Insurers, researchers, and consumers are struggling with the price transparency files required under the No Surprises Act. This post reviews how a public network ID could make these files smaller and more accurate. We’ve previously written about the many benefits of a public identifier for networks (here, and here). Background Under the No SurprisesContinue reading “How a Consumer Network ID can make price transparency files smaller and more accurate”
Author Archives: Eric Ellsworth
Like provider directories, drug lookups have many data quality problems
Part of helping consumers shop for health insurance is helping them determine which plans offer the coverage for their medication needs with the lowest costs and the fewest hassles. Health insurance companies create lists called formularies that show which prescription drugs are cover by each health plan. Right now, these formulary lists have a lotContinue reading “Like provider directories, drug lookups have many data quality problems”
How a Consumer Network ID could provide the line of sight that is needed to make healthcare shopping work for consumers
Healthcare shopping is highly complex, and consumers often have a hard time understanding the financial impact of choices they or their doctors make. In practice, healthcare shopping remains so burdensome that most consumers rarely shop for value, if they shop at all. While surveys reveal great interest in healthcare prices, price estimation tools deployed byContinue reading “How a Consumer Network ID could provide the line of sight that is needed to make healthcare shopping work for consumers”
Checkbook/CSS Response CMS RFI for a National Directory of Healthcare Providers
Checkbook/CSS Response to CMS RFI for a National Directory of Healthcare Providers CMS’s proposed NDH would provide critical infrastructure to ease burden on providers and insurers and improve accuracy; clear definitions of provider organizations and appropriate accountability are key for success. Earlier this fall, Centers for Medicare & Medicaid Services (CMS) took an importantContinue reading “Checkbook/CSS Response CMS RFI for a National Directory of Healthcare Providers”
Getting to No: Provider Directories are Missing a Key Use Case
While the subject of provider directory accuracy has received a great deal of attention, much less has been written about the user experience (UX) of provider directories. As students of UX know, good design starts from a deep and empathetic understanding of the user’s goals and mindset; in the design process these are captured throughContinue reading “Getting to No: Provider Directories are Missing a Key Use Case”
Consumer Network ID – A Proposal for Helping Consumers Understand Coverage of Doctors They Care About
Consumers’ ability to make use of their health insurance depends heavily on their ability to see in-network doctors, as health plans generally offer limited or no coverage of care from providers outside their networks. However, for a consumer to determine whether a particular doctor is in their plan’s network they must get through a processContinue reading “Consumer Network ID – A Proposal for Helping Consumers Understand Coverage of Doctors They Care About”
New Consumer Testing Shows Limited Consumer Understanding of Short-Term
Plans and Need for Continued State and NAIC Action
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The Roles Of Assisters And Automated Decision Support Tools In Consumers’ Marketplace Choices: Room For Improvement
Assisters provide in-person and phone-based support to help consumers narrow their plan options on the Affordable Care Act’s health insurance Marketplaces. We elicited the perspectives of a national sample of thirty-two assisters from ten states on consumer plan selection and available Marketplace decision support tools (for example, total cost estimators and provider network look-up tools).Continue reading “The Roles Of Assisters And Automated Decision Support Tools In Consumers’ Marketplace Choices: Room For Improvement”
Helping Consumers Choose Health Plans In Exchanges: Best Practice Recommendations
The Health Insurance Exchanges required under the Patient Protection and Affordable Care Act (ACA) have the potential to create markets that will help millions of Americans get affordable health insurance coverage and access to high-quality care. The exchanges can enhance consumer and employer buying power to improve the overall quality and efficiency of the healthContinue reading “Helping Consumers Choose Health Plans In Exchanges: Best Practice Recommendations”
Consumers’ CHECKBOOK Expert Explains, Demonstrates Key Features of Health Plan Comparison Tool in Speech at the World Health Con
In an effort to educate health-care leaders about providing a well-designed, consumer-friendly health plan comparison tool as part of the health insurance Exchanges being developed under the Patient Protection and Affordable Care Act, Robert Krughoff, president of nonprofit Consumers’ CHECKBOOK, recently spoke at the World Health Congress on Health Insurance Exchanges and demonstrated key features ofContinue reading “Consumers’ CHECKBOOK Expert Explains, Demonstrates Key Features of Health Plan Comparison Tool in Speech at the World Health Con”
