Moving Forward with Relative Prices

 

Last week, DHCFP began collection of total medical expenses data.  This week, we prepare for our second major data collection effort under Chapter 288: relative prices.    

Relative price can be a deceptively complex measure.  Relative prices compare how much a carrier would pay each provider for a standard mix of services across a standard mix of insurance products relative to other, similar providers in a carrier’s network.  However, because these are relative prices, they are expressed as ratios within each carrier’s network.  DHCFP finalized its relative price regulation this past Friday, after months of collaboration and discussion with carriers and other stakeholders.  In June, DHCFP will be collecting relative price data for nine distinct provider groups, including hospitals, physician groups, community health centers, and skilled nursing facilities, among others.

In order to ensure the smooth processing of relative price data, DHCFP will be hosting a technical workshop at 1 p.m. on Thursday, April 7.  During the workshop, DHCFP will review the data specifications for the relative price submission and address any outstanding carrier questions and concerns.  Input from this session will allow us to better refine our data specifications and ensure that the highest quality data is received in June.

We would like to thank carriers for their continued assistance and partnership with respect to total medical expenses and relative prices.  Both of these measures will provide valuable information regarding health care costs and variation in provider payment levels in the Commonwealth and are important tools for transparency.

 

 

Comments

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