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Gundersen Lutheran Health Plan and Franciscan Skemp’s Health Tradition have formalized plans to provide estimates of out-of-pocket costs to enrollees who request them before receiving services.
On Tuesday, the two medical centers were among 17 members of the Wisconsin Association of Health Plans pledging to make health care costs more transparent. The pledge applies to the plans’ commercial enrollment as well as their BadgerCare Plus enrollees who also may have out-of-pocket expenses.
This isn’t really anything new for members of the Gundersen Lutheran Health Plan and Health Tradition.
“We’ve been sharing cost comparisons and offering estimates upon request for out-of-pocket expenses for some time now,” said Patricia Kohn, chief operating officer of the Gundersen Lutheran Health Plan.
“We believe that people have every right to look for the greatest value for their health care dollar, and the best way to do that is to share cost information,” she said.
Steve Kunes, executive director of Health Tradition, said if patients are planning surgery, they can get an estimate, minus benefits, deductibles and co-payments verbally or in written form.
“We haven’t announced it in the past, but we have been doing this for a few years,” Kunes said. “I think it is more important than ever with high-deductible plans for patients to have this important information to make an informed decision.”
Kunes said the estimates, which won’t apply to emergencies, comes with a disclaimer that complications will add to the cost.
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.
Kunes said the transparency initiative goes beyond requirements, giving health plan enrollees the cost information most relevant to them — estimates of what they will be required to pay out of their own pockets.
Terry Rindfleisch can be reached at trindfleisch@lacrossetribune.com, or (608) 791-8227.
