| Increasing the popularity of tiered health insurance plans could help drive down total medical spending, industry leaders agreed Tuesday, but hospitals and insurers aren’t necessarily on the same page about how to do it.
A special commission studying how the state might reduce provider price variation in the health care system agreed Tuesday to explore ways to maximize the market impact of tiered health insurance plans.
Describing their goal as “tiering on steroids,” the group agreed to look at ways to increase the price differential for consumers between the tiers offered in plans to provide greater incentive for consumers to choose lower-priced providers.
Massachusetts Association of Health Plans CEO Lora Pellegrini, however, said insurers would like to see the state require providers, including the high-price academic medical centers, to participate in tiered networks, while hospital leaders said they saw little incentive for them in such a plan.
“I think in general they wouldn’t want to be told they have to contract with a particular plan just because the plan said so,” said Lynn Nicholas, president of the Massachusetts Health and Hospital Association. “That’s really a slippery slope for government to start saying you have to do something, but I do think there are ways to make tiering more effective.”
Tiered health plans offer patients the ability to make choices about how much they are willing to pay for their treatment, while generally providing coverage for services at a more diverse selection of hospitals and doctors than in limited-network plans.
Insurers place hospitals or doctors into tiers, and patients have the option of paying more or less in copays or deductibles, for instance, based on the provider they choose.
Experts on the 23-member panel acknowledged that tiering – even done perfectly – might only make a minor dent in overall health care spending.
Still, hospital, insurance and policy leaders decided it was worth studying what “tiering on steroids” would look like and how much it could save as one of a number of steps the state will need to take to address health care costs.
