Though the idea isn't new, the demand for health care price transparency has reached significant heights in the last couple of years. With high-deductible plans on the rise and out-of-pocket costs sometimes varying greatly depending on the provider and location, patients often don't understand what they owe until after a service is received.
The new price transparency bill
In response to this demand, two house representatives from Texas have introduced the Healthcare Price Transparency Promotion Act of 2016, a bill that would require hospitals and insurers to offer cost information to patients and beneficiaries before they receive care.
In a joint press release, Representatives Michael Burgess, a Republican, and Gene Green, a Democrat, explained that by allowing individuals to compare prices, this bill has the potential to reduce health care costs.
"The fact that patients rarely know what health care services cost until after they've received them and the wide variety in pricing, make the health care market uniquely difficult to navigate," Representative Green said in the release. "Greater transparency around prices of health care services will enable patients and families to choose lower-cost, high-value care and promote competition in the market."
Properly implementing price transparency
Advocates for price transparency have long made the same argument, according to Quality Matters, a Commonwealth Fund publication. Others see price transparency as a way to promote patient engagement, which is also believed to reduce costs.
"Others see price transparency as a way to promote patient engagement."
When Blue Cross Blue Shield of North Carolina decided to publish the prices it pays for certain services at points of care throughout the state earlier in 2016, many hospitals and health care systems in the state balked at the decision, saying it confused patients and didn't really give them a full picture of what they're paying for, according to HealthLeaders.
However, Ron Paulus, the president and CEO of Mission Health based in Asheville, North Carolina, told HealthLeaders that, if executed properly, price transparency could help patients make more informed decisions.
"We know that patients [who] are more engaged in their care feel more empowered, have better clinical outcomes, and cost less," Paulus said. "The open question is, how do we engage consumer-patients more effectively? We are working hard in this area but have a long way to go. We are committed to making the journey."
Paulus explained that, in order for price transparency to actually achieve its desired ends, it has to clearly tell patients exactly what they can expect to pay as accurately as possible. Pure data, as provided by BCBSNC, doesn't do so.
To avoid that confusion, this newly introduced bill would ask providers to research what types of cost information would be useful to patients, how that information varies based on health insurance coverage, and the best ways to communicate it.
For more health care news, information and resources that can strengthen your hospital's level of care while protecting your bottom line, contact Professional Medical Services today.
