From The Commonwealth Fund: Hospital patients usually receive a complex package of services during an episode of care, such as a knee replacement. Hospital prices should be presented the same way, rather than as a list of prices for individual services. Price transparency, in the absence of corresponding information about quality and out-of-pocket-costs, can lead to poor health care choices and higher costs. The core elements of effective price transparency that Congress, the Trump administration, and private payers could consider in crafting policies that will effectively empower patients to be better purchasers:
- Focus transparency efforts on products and services that are truly shoppable, such as some prescription drugs or diagnostic imaging.
- Group health care products and services into units that patients can wrap their heads around, such as episodes of care, procedures, or the annual cost of care.
- Combine pricing data with data on quality or health outcomes.
- Present standardized data in the same format, in a centralized, convenient location — similar to the Medicare Plan Finder tool, which lets Medicare beneficiaries compare estimated total annual out-of-pocket costs for all Medicare Advantage and Part D plans available to them.
- Require price information be made available to physicians and other providers that direct patient care but rarely know the prices or quality of the services they deliver.
- Give patients the help they need — whether technology or care navigators or counselors — to weigh quality, cost, and convenience.
- Encourage more shared decision-making around treatment options, so that patients’ out-of-pocket costs become part of the equation.
- Hospital Price Transparency: Making It Useful for Patients. The Commonwealth Fund. February 12, 2019