Doc Lookup Piloted in Marketplace’s Health IT Infrastructure
Beta testing will reach about 25 percent of randomly selected visitors to HealthCare.gov as they compare insurance coverage options.
- Some visitors to HealthCare.gov will now be part of beta testing for a doctor lookup feature within the health IT infrastructure of the federal insurance marketplace. The pilot project, announced Nov. 3 by the Centers for Medicare and Medicaid Services (CMS), incorporates validated data from insurance companies about which doctors and facilities are in their networks.
CMS said beta testing would be phased in to reach about 25 percent of randomly selected visitors to HealthCare.gov as they compare coverage options. Health Insurance Marketplace CEO Kevin Counihan said the piloted feature is the direct result of consumer demand. “Our goal is to provide consumers with relevant, personal and more up-to-date information about a plan before enrolling. We thank the Marketplace health plans who have now made this information available to the public,” he noted.
HealthCare.gov has access to data from over 90 percent of insurance companies on the marketplace, according to CMS. During the pilot phase, CMS will analyze the quality of provided data based on consumer feedback.
The agency cautions that in the early stage of testing some data may be missing or inaccurate. If an insurance company has not provided validated data, consumers will receive an alert when searching for a provider that there is “no data from insurance company.” CMS also said it would be providing technical assistance to insurance companies that have not yet provided access to their data.
“Consumers are reminded that health plans can change which doctors and facilities are in their network on a continual basis and providers can change locations and affiliations frequently,” according to CMS. “That is why we’re encouraging consumers to check with their doctor or plan to confirm that the doctor accepts that plan. Consumers will be asked to opt-in to use the tool to be sure they understand limitations with the data and will be able to leave comments directly through the site.”
In coming weeks, HealthCare.gov also expects to pilot a prescription drug check feature.
"The future for CMS is to create an open-source environment that drives innovation for the consumer. By requiring data transparency from health plans and providers and by releasing the information in a machine readable format, we are using consumer demand to accelerate that change," said CMS Acting Administrator Andy Slavitt in a prepared statement. "This fits in with our strategy and should make experiences like Marketplace Open Enrollment better for consumers."
Enrollment in HealthCare.gov and state insurance marketplaces created under the Affordable Care Act started on Nov. 1 for people who want to continue or start health coverage Jan. 1, 2016. Federal officials said about 40,000 applications were submitted through HealthCare.gov during the first six hours of open enrollment. An estimated 10.5 million uninsured people are eligible to get coverage on the exchanges.
Health and Human Services Secretary Sylvia Burwell has been advocating for consumers to shop around on HealthCare.gov or state exchanges. Speaking on a conference call earlier this week, Burwell said the average rate increase in ACA plans for 2016 is about 8 percent, compared to 2015 rates. However, she added that a large majority of consumers receive federal subsidies to help pay for the premiums.
