Aetna Shares ’Price Tag’ For Physician Services With Members
First of its kind program developed with feedback from physician community; Ohio, Kentucky & Indiana consumers to access information as part of pilot
HARTFORD, Conn., Aug. 18, 2005 — Aetna (NYSE: AET) today announced the first program of its kind to let consumers find out what they can expect to pay at the doctor’s office before going in for a visit. This means that, for the first time, consumers can better gauge their out-of-pocket health care expenses by having online access to the actual discounted rates for up to 25 of the most common office-based services offered by their own primary care or specialist physician. The program will initially be piloted with information for approximately 600 distinct procedures provided by 5,000 individual physicians and physician groups in Cincinnati, Dayton and Springfield, OH, Northern Kentucky and Southeast Indiana.
“As an industry, we need to make it simpler and easier for consumers to access information that will support them in making well-informed health care decisions,” said Aetna President Ronald A. Williams. “The biggest impediment to effective consumerism in health care has been the unavailability of relevant data on health care quality and cost. We’ve made great strides in providing consumers with details on quality through our Aexcel high performance networks, Hospital Comparison Tool, and the ‘Rate Your Medical Professional’ survey on DocFind. Now, we are complementing those efforts by taking the lead on opening what is often perceived as the ‘black box’ on physician-specific pricing.
“Ultimately, consumers need to make the health care decision that is right for them and their families. We encourage them to take a look at the quality and cost information that is currently available, and discuss these issues directly with their family physicians.”
As more and more Americans begin managing their health care dollars, they are increasingly interested in the “price tag” for the health care they receive. Through this enhancement, Aetna members will see the actual discounted rates specific to their health plan for office visits, diagnostic tests and minor procedures. The published information will vary based upon the physician’s specialty and will be expanded over time based on feedback.
Because this level of detail is new to consumers, Aetna solicited feedback from the physician community to guide the creation of this program. Focus groups were conducted with physicians and their office staffs in the Cincinnati area, and Aetna met separately with representatives from local and state physician professional organizations as well as large group practices in Ohio. Feedback gathered during this process was incorporated into the program.
“I applaud Aetna for taking a significant step toward transparency of health care pricing,” said Regina Herzlinger, the Nancy R. McPherson Professor of Business Administration, Harvard Business School. “Consumers should know how much a service will cost them before they make the purchase, and health care should be no exception.”
"The industry has long taken the position that health care pricing is proprietary, and therefore has not shared the true costs of medical services with consumers on a prospective basis -- only after care is received," said Ray Herschman, National Consulting Practice Leader, Mercer Health and Benefits Consulting. "Employers and consumers will be very encouraged by Aetna's pilot program; we believe this important milestone, on the road to a more transparent consumer-driven healthcare marketplace, will lead to more of this important information being shared with consumers."
“When a patient enters my office they should feel confident that they have enough information to discuss their health care issues with me and my staff,” said Donald Nofziger, M.D., a pediatrician who practices in Cincinnati. “Increasingly, cost is one of the issues that they’re interested in knowing more about. I think Aetna’s approach to providing pricing information provides one more piece of data to help my patients make wise decisions, and I look forward to helping my patients understand what this information means to them.”
To access the information, members log-on to Aetna Navigator (www.aetna.com), Aetna’s password-protected member website, search for their physician using “DocFind,” and choose “View Rates for Aetna Members” on the “Provider Detail” screen. Aetna will solicit additional feedback from physicians, customers and members prior to rolling the program out in other markets.
As one of the nation’s leading providers of health care, dental, pharmacy, group life, disability and long-term care benefits, Aetna puts information and helpful resources to work for its approximately 14.435 million medical members, 12.976 million dental members, 9.117 million pharmacy members and 13.662 million group insurance members to help them make better informed decisions about their health care and protect their finances against health-related risks. Aetna provides easy access to cost-effective health care through a nationwide network of more than 684,000 health care professionals, including over 405,000 primary care and specialist doctors and 4,135 hospitals. For more information, please visit www.aetna.com. (Figures as of June 30, 2005)
Take A Tour of Aetna's Physician-Specific Transparency Tools 
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