In just the second in-person staff trip since the beginning of the pandemic in 2020, the KHC staff attended in June the National Alliance of Healthcare Purchaser Coalitions Leadership Summits in Detroit. The two-day event focused on fiduciary and affordability, rebuilding trust and transparency, and humanistic health. Below is a round-up of the themes discussed at this summer’s Leadership Summits.
Federal Transparency in Coverage Rules and Consolidated Appropriations Act
Both the Federal Transparency in Coverage Rules and Consolidated Appropriations Act (CAA) establish specific fiduciary responsibilities for employers and other healthcare stakeholders. The deadline for employers to comply with the Federal Transparency rules was July 1 and the penalty for noncompliance is $100 per day/per violation for each affected member. The rule requires employers to:
- Disclose cost-sharing information upon request
- Make cost-sharing information available on an internet website
- Disclose in-network provider negotiated rates
The employer deadline to adhere to the CAA health provision rules is December. These rules are similar to the retirement plan rules implemented several years ago to improve transparency and fiduciary responsibilities related to 401(k) and other retirement benefits. CAA employer fiduciary responsibilities fall across four key areas:
- Removes gag clauses from service provider contracts on price and quality information
- Establishes reporting requirements
- Requires the disclosure of direct and indirect compensation from all service providers
- Requires parity in substance abuse and mental health benefits
Sage Transparency is a free tool that combines hospital pricing and quality data. The value to employers and others includes the ability to understand and know actual costs, design benefits to controls costs while providing quality services, and meet fiduciary responsibilities.
Sage Transparency is an outgrowth of the Employer’s Forum of Indiana’s work related to the RAND Hospital Price Transparency Study, which the KHC has participated in since its second release. The Sage tool combines data from RAND 4.0, the National Hospital Price Transparency Study, National Academy for State Health Policy (NASHP), Centers for Medicare and Medicaid Services, Turquoise Health, and Quantros/Healthcare Bluebook. The tool gives users access to price and quality data for thousands of hospitals across the United States in an interactive, customizable dashboard which displays data from a variety of sources in an easy-to-understand way.
Roe v. Wade Supreme Court Decision
Multiple speakers at the Summit addressed the recent Supreme Court decision overturning Roe v. Wade from a health policy and benefit design perspective. As an employer led, multi healthcare stakeholder organization, the KHC is focused on helping members think through the impact of this massive change on benefit design and human resources policies from the perspective of women’s reproductive health, such as what benefits your health plan covers related to reproductive health services and what human resources policies and benefits are in place or may need to be changed, related to travel or time off, to support reproductive health benefits.
The KHC is hosting an Employer Roundtable August 17 to provide employer members the opportunity to discuss the issues employers are navigating related to women’s reproductive health in the current healthcare landscape.