The transformation in the American healthcare system imposes new and evolving obligations on providers and the rest of the healthcare industry. Healthcare spending continues to outpace inflation leading to a consensus that the status quo is not sustainable.
Read: Price transparency: A significant force in healthcare
The Affordable Care Act (ACA) has changed not only how the health insurance market operates; it also contains mechanisms to slow the growth in cost of care and to improve quality of care.
The traditional system for pricing healthcare is seen as a barrier to reducing costs. Princeton economist Uwe Reinhardt famously described the healthcare purchase as shopping blindfolded, referring to a lack of transparency into price and quality of healthcare services.
Advocates for healthcare transparency believe opacity tolerates wide variations in prices and quality for similar services and is an impediment to achieving the triple aim of: (1) improving the patient experience; (2) improving healthcare quality; and (3) reducing healthcare costs.
Current trends in coverage cause patients to bear an increasing share of their healthcare costs. High-deductible health plans and certain ACA plans offer lower monthly premiums along with larger copayments and deductibles. As a result, patients are becoming more cost conscious. Health policy experts generally agree that properly tailored transparency tools can help to hold down prices.
What is not settled at this point is what transparency should look like…
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