News Briefs

CMS on Oct. 29 finalized its insurer price transparency rule, drawing quick rebukes from the industry. The rule will require plans, starting on Jan. 1, 2023, to offer online shopping tools “that will allow consumers to see the negotiated rate between their provider and their plan, as well as a personalized estimate of their out-of-pocket cost for 500 of the most shoppable items and services.” Effective one year later, those shopping tools will have to show the costs for all remaining items and services. Insurers must also meet a Jan. 1, 2022 deadline to “make publicly available standardized and regularly updated data files, which would open new opportunities for research and innovation to drive improvements within the healthcare market.” America’s Health Insurance Plans said in a statement that by forcing insurers to reveal negotiated rates, “the final rule will work to reduce competition and push health care prices higher — not lower — for American families, patients, and taxpayers.” The rule was first proposed in November 2019 (HPW 11/25/19, p. 1). Visit https://go.cms.gov/37SEc3Z.

The health systems Intermountain Healthcare and Sanford Health, which both operate insurance plans, said on Oct. 26 that they are planning to merge. Citing a desire to “further implement value-based strategies and realize economies of scale” as their motivation for combining, the two not-for-profit organizations said they expect their deal to close in 2021, pending federal and state approvals. Intermountain Healthcare-owned SelectHealth covers a total of 903,370 medical lives, and Sanford Health Plan covers 200,515, according to AIS’s Directory of Health Plans. During a call with reporters, Sanford Health CEO Kelby Krabbenhoft indicated that growing the organization’s health plan was a primary motivator for the deal, according to FierceHealthcare. Read more at https://bit.ly/3mqxOoE and https://bit.ly/3jyMQqB.

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AIS Health Staff

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