The Bulletin

More shopping for health care in Virginia is a step closer to reality

By: - January 28, 2019 5:01 am
Virginia Mercury

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.

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Katie O'Connor
Katie O'Connor

Katie, a Manassas native, has covered health care, commercial real estate, law, agriculture and tourism for the Richmond Times-Dispatch, Richmond BizSense and the Northern Virginia Daily. Last year, she was named an Association of Health Care Journalists Regional Health Journalism Fellow, a program to aid journalists in making national health stories local and using data in their reporting. She is a graduate of the College of William and Mary, where she was executive editor of The Flat Hat, the college paper, and editor-in-chief of The Gallery, the college’s literary magazine.