Premera On “Transparency” And APCD

This statement from Premera was released on March 10th in a producer email.  We missed in then, but are posting the statement now.

—————————————

Jeff Roe
President
Premera Blue Cross

You may have seen one or more of a number of media articles in the recent days on the legislative issues in Olympia that discussed Premera with regard to transparency in healthcare. The legislative issue receiving the most coverage is a bill for the state’s Healthcare Innovation Plan, which includes an “All Payor Claims Database.”
Here’s what you should know about our position on this issue.

Premera strongly supports empowering consumers, employers, and providers with information to make informed choices about the use, purchase, and delivery of healthcare.  There is a difference, however, between meaningful transparency and a database. We have serious concerns about the All Payor Claims Database as proposed in Olympia. Here are our concerns on this database as proposed in the original bill and covered in the media.

–  It doesn’t provide actionable information for consumers. The database would show reimbursements from health plans to providers to pay for medical claims, but would not be able to filter that information through the lens of the consumer’s benefit plan.

–  It will increase, not lower medical costs.  Our experience and that of other payors is that market intelligence on allowed amounts is used by providers to negotiate higher, not lower reimbursements.

–  It may add direct costs for employers.  The cost of the database may end up in premiums if the state chooses to tax employees and/or payors to build and maintain it.

–  It presents significant concerns for personal privacy. Personal medical claim information would be stored in a state government database. This should be a concern for consumers, as it would significantly expand access to personal health information.

The legislature is still in session so new options on ths issue may emerge. It is possible given our concerns that we could support a database with a narrower, targeted scope.

We are interested in a productive, informed, and reasoned dialogue on this issue. We’ve worked extensively with stakeholders in the past to improve outcomes for patients and lower costs, and we will continue that in the future.

Thank you for your continued support of Premera.