Price transparency seems to be the next great movement within healthcare. Supporters feel that if patients are informed about the cost of healthcare services, such as MRIs, lab tests, etc., they may exercise caution in utilizing those services. With widespread adoption, this could potentially save billions of dollars and significantly improve care quality.
Such information is also becoming more readily available. Some employers are providing employees with a range of pricing information for providers in the area; the Centers for Medicare and Medicaid Services (CMS) has released claims data; there are laws in some areas requiring providers to list pricing information.
As more and more people are starting to get their health insurance outside of their employers, they are eager to know what they’re paying for. High-deductible health plans are becoming increasingly common. According to America’s Health Insurance Plans, almost 15.5 million Americans had a high-deductible plan in January 2013.
A reference pricing system has been implemented in some large chains. What this means is that if employees select a provider costing more than the reference price, they’ll pay the difference out of pocket.
Though price transparency seems to be a popular and quickly growing idea, there are a few challenges that come along with it. Most physicians aren’t trained in business, so things like cost and pricing can be tough to understand. Talking about prices can be difficult for some providers who don’t feel comfortable discussing the subject. It also seems that it’s easier to list a flat rate for surgical procedures as opposed to services provided at an office. As the demand grows, however, these challenges must be overcome.
Author: Apoorva Anupindi