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The 17 members of the Wisconsin Association of Health Plans are pledging to help their consumers make more informed health care decisions by making health care costs more transparent.

Each of the Association-member health plans signed a pledge to begin providing, by September 1, estimates of out-of-pocket costs to enrollees who request them before receiving services. Also by September 1, each plan will inform their enrollees that the out-of-pocket cost estimates are available.

“The rising cost of health care services is pushing health insurance premiums higher and taking more money out of consumers’ pockets,” said Steve Youso, Chief Administrative Officer of Security Health Plan and President of the Wisconsin Association of Health Plans Board. “The cost information we can provide will give consumers a better position from which to evaluate health care options and make more fully informed decisions.”

Current state regulations require health plans to provide, upon request, descriptions of their coverage terms and estimates of allowable charges for a specific service from a specific provider. The Association transparency initiative goes beyond current requirements to give health plan enrollees the cost information most relevant to them: estimates of what they will be required to pay out of their own pockets.

The pledge applies to the plans’ commercial enrollment as well as their BadgerCare Plus enrollees who may have out-of-pocket expenses.

“Today’s initiative is an important step in the progression of health care transparency efforts in Wisconsin,” said Nancy Wenzel, Chief Executive Officer of the Wisconsin Association of Health Plans. “Health plans were instrumental in developing standardized quality measures, and now we’re doing our part to improve cost transparency.”

Wisconsin health plans participated in the development of what is now called the Healthcare Effectiveness Data and Information Set (HEDIS), a growing set of standardized measures of performance in health care delivery. All Wisconsin health plans collect and publicly report HEDIS measures.

State legislation proposing new transparency requirements for providers and insurers was introduced during the last Legislative Session, but the proposals died when the Legislature adjourned.

Health plans are at different stages in developing the capability to bring greater cost transparency to a broad array of health care services. Some health plans, for example, have created Web sites providing estimates of costs for a set of procedures along with quality information, in recognition that one should not be considered without the other. But all Association-member health plans are committed to giving consumers access to information on their expected out-of-pocket cost obligations.

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Association Member Health Plans

Abri Health Plan

Anthem Blue Cross Blue Shield

Arise Health Plan

Children’s Community Health Plan

Dean Health Plan

Group Health Cooperative of Eau Claire

Group Health Cooperative of South Central Wisconsin

Gundersen Lutheran Health Plan

Health Tradition Health Plan

Humana, Inc.

Managed Health Services

MercyCare Health Plans

Network Health Plan

Physicians Plus Insurance Corp.

Security Health Plan

UnitedHealthcare of Wisconsin, Inc.

Unity Health Plans Insurance Corp.