Starting last year, state employees have the option of shopping for their health care services. Through their health plans, they can shop for procedures like X-rays or mammograms, and if they choose a cheaper option, they pocket some of the savings.
During the 2018 General Assembly session, the attempt to bring that option to the rest of the state failed, but the push was revived this year and, with a few adjustments, now seems more palatable to some of Virginia’s lawmakers.
A bill, sponsored by Del. Kathy Byron, R-Bedford, unanimously passed the House Commerce and Labor Committee and has landed on the floor. It would require health plans in Virginia to create a tool on their websites so members can shop between providers, and then develop a program, approved by the state commissioner of insurance, that would allow patients to share in the savings if they choose a less expensive option.
Sen. Siobhan Dunnavant, R-Henrico, has a similar bill in the Senate.
“This legislation protects the right of a patient to receive care where they choose in consultation with their doctor,” Byron told a Commerce and Labor subcommittee. “If they choose a provider who charges less than the average cost in their network, the insurer shares in these savings with the patient. This gives everyone skin in the game.”
This year’s version of the bill differs in a few ways.
It applies to four service categories, including physical and occupational therapy; radiology and imaging; laboratory; and infusion therapy services. It also exempts plans that have narrower provider networks, like Kaiser Permanente, and has a delayed start date so the plans have to develop their transparency tools by 2020 and the shared-savings program by 2021.