Regarding the article “CMS might not have power to make hospitals disclose negotiated prices,” the challenges of publishing the net effective price of each provider/payer contract are real. But the defense of the status quo is misleading. To achieve true transparency, the micro-monopolies created in today’s healthcare system must be fully eliminated, and the providers must be given control of pricing.
It’s actually quite easy and would have a significant and immediate impact on quality and price. Each provider must set a price for each service. Providers in the same community can have different prices, but those prices must then be published. The information would be easy to access and understand. The customer—known today as the patient—can easily engage in the quality and price conversation to create a value-based decision according to what they view as important. In a free-market system, customers will actually have access to actionable information, and payers—insurers, third-party administrators, employers—will have to compete based on their ability to provide better education, value and communication.
People do care a great deal about total cost of care. The problem has been a system that conspires against them and has for decades—“Don’t worry about what it costs, insurance covers it.” How many times have we heard that? For too long, the system has trained the customer to not care, to deflect the conversation and to avoid the conversation over price, quality and value. It has to stop. But only by the providers getting control of their pricing, and then needing to defend it in the marketplace, will the problem be solved.
Cottingham & Butler