The quality of data on the cost of healthcare services available through private and public transparency initiatives varies greatly, usually because of legal and technical obstacles erected by assorted healthcare entities, according to a Government Accountability Office report.
GAO: Quality of healthcare price data varies widely
The report, based on an analysis of eight government and private initiatives that provide healthcare price information to consumers before they receive care, sought to gain insight into the obstacles to greater price transparency. Greater patient awareness of specific providers' prices for each service, according to some healthcare experts, could help lower prices through free-market competition.
Barriers to the release of such price information, the GAO found, included clinical uncertainties. For instance, GAO investigators were told by physician offices' representatives that before they could learn the price of a screening test they would need to undergo an exam to determine if the test was needed.
Insurance barriers to complete cost estimates, according to provider representatives, included the lack of knowledge by providers of the details of an individual's insurance coverage. For example, the cost of a given service might vary based on the amount the insured person already had spent toward his or her deductible.
Meanwhile, provider barriers to transparency initiatives, according to the GAO's interviews with insurer representatives, included the view of some providers that price data is proprietary information.
Additionally, the report identified several legal factors that may prevent the disclosure of negotiated rates between insurers and providers, such as contractual obligations prohibiting the sharing of negotiated rates on insurers' price transparency websites.
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