Gag clauses in insurance contracts are often cited as a challenge to improving price transparency. But how pervasive are they?

Many healthcare providers and insurers are barred from disclosing contracted prices because of gag clauses and other types of confidentiality agreements. To get a feel for how common gag clauses still are in the healthcare industry, HFMA conducted an informal poll of HFMA Forum members.

Forty Forum members shared details on their organizations’ experience with gag clauses. While the sample was small, the anecdotal results support the belief that there is widespread use of gag clauses in the industry.

The Current Norm

Almost half of respondents report that more than 80 percent of their managed care contracts include gag clauses (see the exhibit below).

Forum Poll-Percentage of Managed Care Contracts with Gag Clauses

No Changes in Recent Years

Seventy-five percent of respondents report that the prevalence of gag clauses has not changed over the past three years (see the exhibit below). Seven respondents said they’ve seen an increase in these clauses.

Forum Poll-Has the Number of Contracts with Gag Clauses Changed in the Past Three Years?

Price Transparency Challenges

HFMA thanks all the Forum members who took part in this informal poll. As HFMA and other industry stakeholders begin to address the challenge of price transparency, it is important for healthcare finance leaders to contribute by sharing their experiences.

The article is based on an informal feedback collected Jan. 27-Feb. 11, 2014. Forty Forum members responded to this poll; 39 from provider organizations and one from a payer organization.

Please comment on this poll in the comment section below.

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