The recent Executive Order regarding health care price transparency has many folks in the health care industrial complex contemplating litigation aimed at highlighting ways in which the order may contravene existing law. It is also unpopular because list price transparency may well have the opposite of the desired effect — it may increase prices in certain circumstances rather than reduce them.
See my post on the health care pricing transparency Executive Order, and my recent Inside Digital Health column on the same topic. In a sense, the key thing to consider is that we all want to know what our bottom-line cost of health care services will be, specific to our own health plan, and our own provider. There are tools out there that can deliver this information, and the pity is that more provider organizations don’t use them. Doing so could improve customer / patient satisfaction immensely.
The administration seems to be trying to get a jump on pending congressional activity in this realm and delivering some version of transparency. In the process, the administration is garnering support from some patient advocates and generating opposition by some associations representing payers and providers.
If you are experiencing a little déjà vu, that’s understandable; the idea of making price and quality data about “shoppable” healthcare services easily available to all is by no means new. Transparency, on its face, seems like it must be a good thing. Alas, nothing is that simple. The key issues, now as always, include at least two key categories of questions:
1. Are the requirements legal? The principal issue here (assuming we get over the question of scope of executive authority and conflicts with existing law), is whether the requirements are anticompetitive or procompetitive. For example, will mandating the release of price data result in all prices for a given service rising to the level of the highest price for that service disclosed in any given market?
2. Would compliance yield meaningful data to consumers, enabling informed decision-making about healthcare services and providers? In other words, will cost and quality measures be linked in a manner that is accessible to and understandable by typical consumers? Will the information be shared in a user-friendly format, through a user-friendly channel and in a user-friendly manner?
Transparency is a hot topic, and my most recent podcast addressed the same issue from a different perspective.
Read more here.
The Harlow Group LLC
Health Care Law and Consulting