Tuesday, May 9, 2017

Price transparency in health care is thwarted by providers and others who want to keep deals secret; crowdsourcing may help

Trudy Lieberman
People seeking information on costs of health procedures are frustrated by the lack of clarity from medical providers. Things are not looking up for Americans seeking health-care price transparency, writes Trudy Lieberman in her latest column for the Rural Health News Service.

True price transparency would allow consumers to evaluate costs and plan for elective procedures or services that aren't covered by their insurance, in order to make informed decisions. Unfortunately, it's not that simple, Lieberman writes. Prices are negotiated, often in secret, between insurance companies, hospitals and doctors. One provider can charge different fees for services according to the type of patient and payment method.

Powerful lobbying interests have prevented health-care price transparency. Ohio passed a law last year to require doctors, hospitals and other health-care providers to disclose prices for their services, "but Gov. John Kasich, the Ohio Hospital Association and other health groups that oppose transparency have stymied implementation," Lieberman reports. "The governor’s budget for next year calls for repealing the law."

Lieberman interviewed patients in Nebraska, South Dakota and California who are “downright angry” and demanding information, she reports. They expressed concerns about hospitals intentionally keeping patients in the dark. A California woman made more than 10 phone calls trying to plan for an outpatient procedure, only to find an expected additional $5,706 on her bill.

Lieberman also spoke with Jeanne Pinder, founder and CEO of ClearHealthCosts. The organization with journalism-based roots seeks to empower people looking for information on medical costs. It gathers from people from all over the U.S. insurance companies' explanations of benefits. Their crowd-sourcing approach to price transparency reveals an inexplicable variety in costs, from hundreds to thousands, and codes for procedures. They use the information to maintain a searchable database that generates price reports by ZIP code and region.

Such information sharing via the internet, with a community approach, could be the key to price transparency, Lieberman ventures. Pinder says the “fix” for public frustration and anger is transparency.

But some caution that knowing prices will not necessarily cut health-care costs. Cost does not always equate with quality, but Americans want more price transparency. One in five have compared costs before seeking treatment, according to a Public Agenda report. And most people think that comparing prices has saved them money.
Public Agenda chart

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