Health Insurance Marketplace Transparency Tool: Out-of-Pocket Costs for Specialty Conditions
Empowering Health Care Consumers
November 15, 2016
Outside New York State
Too often the health care system puts patients last, when they should come first. Consumers and patients are frequently marginalized, rather than placed at the center of the health care system and treated as its most important customers.
The interests of providers, payers, and other organized stakeholders take precedence over the patient in many cases. NYSHealth seeks to amplify the voice of the health care consumer and increase the information and tools available so that patients have more influence over their health and health care. To change the current dynamic and increase health care consumers’ choice, control, and convenience, NYSHealth issued a request for proposals, Empowering Health Care Consumers in New York State. Through this initiative, NYSHealth is funding ambitious, large-scale projects and studies to increase consumers’ access to their own health information; provide new tools and resources that will inform consumer health care decision-making; and identify strategies that meaningfully engage consumers in determining the types of health care services available in their local communities. NYSHealth awarded IMPAQ International a grant to participate in this initiative.
Under this grant, IMPAQ International will create a consumer tool, NYPlanCosts Calculator, to provide New Yorkers with meaningful and transparent out-of-pocket cost estimates—by health plan—for specific high-cost, common conditions. Many health care costs are hidden, showing up after treatment in unexpected bills and putting higher cost burdens on patients. Existing tools that offer consumers estimates of their out-of-pocket costs often provide generalized estimates that can be confusing or misleading. This project by IMPAQ International will make information available through a user-friendly consumer tool so that New Yorkers can make informed decisions when selecting a health plan that best fits their medical needs.