A presentation of information about transparency in healthcare reform. States are currently pursuing ways to make pricing information available to people before they even need it.

1. Pricing Transparency in
Healthcare Reform

2. Many Americans don’t
know exactly how their
healthcare providers come
up with prices.

3. According to a recent
report by non-profit
Catalyst for Payment
Reform, this is the fault of
the providers themselves,
who are rarely transparent
with their pricing methods.

4. They recently gave 45 US
states a failing grade for
neglecting to provide a way
for patients to understand
their expenses.

5. If patients had access to
data like this, the argument
goes, they would be able
to properly budget for care
down the line.

6. As it stands now, they are
victims of prices as care is
needed.

7. What this failing grade
means is this: if you live
there, you cannot readily
find healthcare prices.

8. With healthcare reform,
more of the cost of care is
shouldered by patients,
which makes meaningful
price information more
important than ever.

9. In the same way that
consumers need to
understand pricing of any
product they buy, they
need to know what
healthcare will cost them,

10. particularly since we
can expect healthcare
to be one of life’s
biggest expenses as we
age.

11. What’s standing in the
way are confidentiality
agreements by insurers,
doctors, and hospitals.

12. Price negotiations are
kept behind closed
doors, and intentionally
kept secret.

13. What results is that
consumers won’t have
data to be able to
choose care providers.

14. One reason this data would
be important is that the same
procedure could have
different prices from hospital
to hospital, or from doctor to
doctor, with no difference in
quality.

15. Sometimes the amount
a consumer’s insurance
company will pay can
vary too, based on a
number of factors
currently not available
to the public.

16. Larger hospitals or
hospital systems have
greater leverage to get
higher reimbursement
prices from insurers.

17. That extra money is
paid by employers and
consumers with higher
premiums and
deductibles.

18. There has been a
recent wave of
legislators bringing
prices for such care to
the public, through laws
requiring transparency.

19. Information repositories, also
known as ‘all payer claims
databases’ are being
constructed, providing
accurate and complete
information about pricing by
hospital and physician.

20. As of now, such public
databases are only in
Colorado, Maine,
Massachusetts,
Vermont, and Virginia.

21. Florida is an interesting
case, as they’ve built a
database, but still
received a failing grade.

22. Their site is managed by the
Agency for Health Care
Administration, and has been
deemed to contain too narrow
a scope of information, as well
as being a clunky site.

23. What information is
present is not well
displayed, or very
helpful.

24. Florida’s legislators are
also not seeking
transparency from
insurers, which is a
necessary piece of the
transparency puzzle.

25. Without this information,
consumers only know how
much the care costs total,
not how much they can
expect to spend out of their
own pocket.

26. Pricing Transparency in
Healthcare Reform