Health Insurers Must Provide “Plain English” Summaries of Benefits, Coverage

Monday, February 13th, 2012
This post was written by Cheryl Miller

Transparency and clarity are the objectives in HHS’s “Plain English” ruling on health plan benefits and coverage. Under the rule, health insurers must provide consumers with simple, understandable summaries about their plans. Roughly 150 million Americans have private health insurance today, and should benefit from the ruling. More on this in our feature story.

Transparency is also a key objective in CMS’s new data for its Hospital Compare Web site consumers can now access hospital infection rates at the more than 4700 hospitals listed. According to the CMS, hospital-acquired infections result in thousands of deaths each year and nearly $700 million in added costs to the U.S. healthcare system.

Healthcare costs are key to a recent study from Virginia Commonwealth University, which finds that the managed care medical home for the uninsured will help curb costs and reduce ER visits for the uninsured. The study, which focused on nearly 27,000 uninsured adults over a seven-year period, found that when they had access to regular healthcare their ED visits and inpatient admissions declined, while their primary care visits increased. Researchers concluded that savings in healthcare costs were cut by nearly half.

And lastly, costs are also key to a recent Rand Corporation study on declining prescription drug costs. While costs on brand name drugs have decreased because of increased purchases of generic drugs, drug costs in general remain a hardship for many American families.

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