Starting in fall 2013, US consumers can expect to see more health insurers utilizing a star-rating system. The new approach in healthcare coverage aims to reflect the quality of insurance plans in relation to costs for policy holders. While federal mandates of this ranking system will not be enforced until 2016, many states are opting to make the switch early in order to handle the anticipated difficulties and questions that will come with the transition. The ultimate goals of the ranking system are to provide consumers transparency and guided assistance in comparing plan factors beyond costs or benefits.
Kaiser Health News recently spoke with Laura Etherton
, a healthcare policy analyst for US PIRG, who notes: "If you've got a history of breast cancer in your family, you may want to know how well that insurance company did to make sure women between 40 and 69 got a mammogram. If you have a history of heart disease, how is that plan doing at making sure that patients with a heart condition get a cholesterol test?"
Some critics question if quality rankings matter when ultimately many consumers focus solely on issues of cost, or, if ranked listings have impact on patients such as those under emergency circumstances.
Medical author Diane Shannon, MD, MPH, said that, despite initial concerns of these ratings, the key advantage from such a program is that it allows patients to use personally relevant cost versus benefit information in selecting effective care. Online rating systems of professionals in other commercial sectors, such as restaurants and hotels, have been commonplace for quite some time. Dr Shannon emphasizes that the need for pricing and quality information is not going to disappear, and that providers should expect to position themselves for the change as market demands for healthcare ranking systems increase.
First year implementation of the star-rating system is anticipated to be a learning experience. The healthcare quality ratings will help patients, and improve health systems in making competitive plans more transparent. However, because many plans offered by 2016 will also be new, there will be no standard measurement of quality in relation to existent plans. Additionally, the ratings must be presented in a way that will be most logical to consumers, as not overwhelm or confuse viewers.
Overall, the ability for patients in the United States to openly compare and contrast healthcare insurance within the next 2 years will certainly be an important issue for providers and practitioners to acknowledge. The sooner they can present their services in accurate and comprehensible ways, the better prepared they will be when the mandate is eventually finalized.
Around the Web
Some States Will Rate Health Plans On Quality This Fall [Kaiser Health News]