Lessons from the Pioneers of Health Care Price Transparency
James C. Capretta
Hospitals are complaining about the Trump administration’s latest proposed rule requiring disclosure of the prices they have negotiated with private payers. They say the burden is excessive and will undermine the ability of insurers to secure discounts for their customers. Lawsuits aimed at blocking the rule might be coming soon.
There’s a sense in some quarters that the whole effort is a waste of time and resources because the complexity of providing care to patients does not lend itself to simple, consumer-friendly pricing before services are rendered. That’s a mistaken sentiment. Meaningful and understandable pricing is not an impossible dream. That is certain because it already exists in small pockets throughout the United States.
One example can be found in the medical systems providing care to the Amish and Mennonites communities, as Katherine Hempstead and Chapin White noted in an article from earlier this year. Segments of these religious groups forgo enrollment in health insurance and instead pay cash for the care they need. Unlike self-insured employers, they do not contract with commercial insurers to administer claims on their behalf. Instead, they work with the hospitals and medical groups located near their homes and farms to secure transparent, all-in pricing for the services they may need.