Liberating Data to Enable Healthcare Market Transparency: A Guide for Regulators and Policy Makers

Funded by Novo Nordisk; Manatt retained full editorial control.

The federal and state Marketplaces established by the Affordable Care Act (ACA) have made it easier for consumers to compare their health insurance options, but data are still not fully available for consumers to understand how their plan options compare on cost-sharing, provider networks, drug access, and what each option might cost them in premiums and out-of-pocket spending. The challenges are more daunting for consumers who purchase coverage outside the Marketplaces, where comparative data are harder to find and consumer tools are more limited.

Despite these limitations, however, the road ahead is clear. We are on the cusp of a transparency revolution. In a new white paper, prepared with the support of Novo Nordisk, Manatt Health shares a four-year Roadmap to Transparency, describing the steps that public officials and private consumers can take to liberate available data to realize the full benefits of a Marketplace in which consumers have ready access to online decision-support tools.

The Roadmap details the changes needed to make sure website and application developers have the data to help consumers use the right information at the right time to make informed decisions on their choice of plan design; formulary; network; providers; and cost of treatment, ideally including comparative costs when consumers are asked to choose between competing treatments. It focuses primarily on the foundational step of making health plan information available in a standardized and timely manner so that designers of consumer tools have full access to the data necessary to develop robust decision-support tools.



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