On October 29, 2020 the Department of Treasury, the Department of Labor, and the Department of Health and Human Services issued the final Transparency in Coverage Rule. The rule, based on provisions of the Affordable Care Act, means that 212 million consumers will be given access to the prices of virtually every test and procedure.
This is a massive change in health care that requires employers to arm consumers with access to comprehensive, transparent, easily accessible competitive pricing options. Initial compliance—via provisions of the No Surprises Act—begins on January 1, 2022. As of January 1, 2023, employers can be fined $100 per insured individual per day for not giving their employees such access, possibly sooner under the No Surprises Act which was passed on a bipartisan basis in December of 2020.
Mark Galvin, Founder and CEO of TALON (https://talonhealthtech.com/), believes the change should be eagerly anticipated by companies because it promises to dramatically reduce their health care expenditures, thus positively impacting their bottom line. But Galvin points out that the requirements of the Transparency in Coverage Rule taken alone, however, won’t be enough to achieve significant-enough cost savings through smart shopping. That’s because insured health care consumers have been taught not to think that their money is actually being spent when they visit the doctor for a procedure or visit a laboratory for a blood test. They have been taught to think of the services they receive as “covered by insurance,” which has come to be synonymous with “free.”
“Variables other than transparency have to come into play in order to motivate consumers to seek out excellent quality care at fair prices,” Galvin said. “One of these is to incentivize insured individuals to select lower-priced options by sharing the savings achieved directly with them—literally giving them some of the money they save. I made this clear to government officials in Washington, DC when I visited with them on multiple occasions and shared the technology we at TALON have developed, which automates such rewards. It gives consumers a stake in the game.”
Galvin added, “Another way to motivate consumers is for them to opt for high deductible health insurance plans. Such plans bring lower premiums. The savings realized are then available to fund triple-tax-advantaged companion Health Saving Accounts, thus reducing over-insurance while assuring funds are available to cover unexpected medical events. And with the tools headed their way by law on June 1, consumers will be able to manage these out-of-pocket health care expenses much more effectively.”
TALON (https://talonhealthtech.com/) has demonstrated that its MyMedicalShopper app, featuring state-of-the art functionality for price transparency, along with automated rewards for employees who choose high quality, but lower-cost health care, can save companies very significant percentages of their costs for healthcare. Dozens of corporations have already signed on with them and are using TALON technology today.
Healthcare is about to change in dramatic and positive ways in America. Thinking through all the ingredients needed to achieve those changes will assure they take hold.
TALON works with Third Party Administrators, including those engaged in ASO arrangements, along with corporations themselves to deploy software that goes beyond merely complying with the Transparency in Coverage Rule and No Surprises Act by offering additional money-saving features that are already proven and easily deployed.
TALON can be contacted at firstname.lastname@example.org.
Release ID: 89022093