The importance of engaging consumers to be more responsible in managing their health and in the purchasing of their healthcare services is a commonly shared belief among industry stakeholders – employers, health plans and providers. These same stakeholders further believe that transparency in pricing and quality is the first step to remedy the woes plaguing America's healthcare system.
Those and other key findings are documented in a recently released report from Deloitte & Touche commissioned by the National Governors Association and conducted by the Deloitte Center for Health Solutions.
Entitled "Health Care Price Transparency: A Strategic Perspective for State Government Leaders," the 24-page report was based on 34 interviews with providers, health plans and employers and 12 interviews with federal and state policymakers, according to survey authors.
Among key findings, the study found that employers are generally predisposed to transparent pricing efforts, believing that competition among providers will be more effective at enhancing transparency than relying on government mandates. Employers also believe, according to the study, that the government can help in reducing "inconsistencies" among states by providing standards and policies for transparent pricing.
The sticking point is that providers, the study found, expect and want the methodology used for comparing prices to be "systematic and fair." Because providers feel that transparency in pricing could encourage a consumer to seek care from a lower-priced provider, they are looking to the government to play a role in assuring "fair play." They are insistent that methodologies accommodate differences in the severity/risks for patient populations.
On the other hand, health plans, according to study, support the use of tiered networks to show relationships between price, quality and efficiency. They believe that displaying comparative efficiency measures will do more to realize greater savings than price information. They see this as an effective strategy to encourage pricing transparency, believing that consumers will realize more value for their healthcare purchases by comparing providers based on all three measures by way of tiers of providers.
Understandably, providers are "concerned" that the complexity of pricing and the difficulty of comparing healthcare facilities would confuse consumers. Employers, however, acknowledge the complexity of pricing, according to the survey, even for the "simplest services," but believe that price transparency will help consumers make more informed healthcare purchasing decisions.
Health plans, the study showed, are unlikely to expose publicly their negotiated rates with providers, believing that this could result in increased consumer prices.
The findings show that all stakeholders seem to support transparency initiatives by state and federal officials, believing that they benefit everyone. In fact, the study cited state quality transparency programs in Pennsylvania, Florida, California and New York that illustrate the differences among hospitals in performance measures. The study also found that 33 states have passed statutes or laws that affect disclosure, transparency, reporting or publication of hospital prices.
Although opinions on the subject of pricing transparency vary, as does the level of participation in such programs, the Mayo Clinic in Jacksonville, Florida, was noted in the study for its implementing a price estimator tool that can tell patients upon admission their approximate out-of-pocket cost.
The study noted that most of those interviewed believed that adoption of price transparency was a "matter of when, not if."
