June 18, 2013
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“To date, most policy activity related to health care price transparency has missed the mark and has not achieved the prime goal of lowering prices by engaging consumers to choose providers on the basis of value. Without changes in insurance benefit designs that steer patients to high-value providersthose that provide high-quality care efficientlyprice transparency initiatives are likely to continue to have limited impact,” testified Ginsburg, who also serves as research director of the National Institute for Health Care Reform, at a hearing of the U.S. Senate Committee on Finance examining health care price transparency.
“At least three distinct audiences have the potential to benefit from health care price information. One audience is individual patients deciding what care to get and which provider to use. Patients need to know the differences in what they will pay if they choose different providers. The second audience consists of employers that purchase health benefits for their employees. For this audience, learning that prices vary a great deal from one provider to another, often in a way unexplained by quality differences, can be very influential. Employers can change insurance benefit and network designs to make employees more sensitive to price and shift use of services to higher-value providers. The third audience is policy makers, who can pursue approaches to increase the degree of price competition in the market or, in some cases, regulate prices directly,” according to Ginsburg.
In his testimony, Ginsburg noted that better information on provider quality is needed to support efforts to use price transparency to obtain lower-priced care, adding, “Consumers need quality data that is meaningful to them before they decide to choose a lower-cost provider. Currently, perceptions of quality are based largely on reputation among clinicians, but it is by no means clear that a good reputation equates with better outcomes.
Ginsburg’s testimony is available here.
The Center for Studying Health System Change is a nonpartisan policy research organization committed to providing objective and timely research on the nation's changing health system to help inform policy makers and contribute to better health care policy. HSC, based in Washington, D.C., is affiliated with Mathematica Policy Research.