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Thursday, June 27, 2013

Healthcare Prices Uncensored: The Shift Towards Price Transparency

The United States has higher costs of healthcare when compared to most other developed nations; however, these prices are not necessarily linked to quality care. With the current structure of U.S. healthcare pricing today, patients have little access to information about medical prices—or quality—prior to undergoing a procedure. And unfortunately, preliminarily obtaining this information is nearly impossible, ruling out any chance of comparison-shopping between hospitals or physicians, as well as the ability for patients to make informed decisions before being hit with a medical bill.

The typical price disparities among hospitals—even those relatively close in distance from one another—can average more than 200% in inflated costs, with little relationship to differences in quality . This remains true even within most preferred provider organization insurance networks. According to a recent TIME cover article by Steven Brill titled “Bitter Pill: Why Medical Bills are Killing Us,” many stakeholders in the health care system profit from concealed price and quality information, including poor-performing and high-priced insurers, providers, and suppliers. They fear (and correctly) that if patients had better access to price and quality differences between the providers available to them, it will likely determine where they seek healthcare services.

While the Patient Protection and Affordable Care Act (ACA) has made significant—albeit preliminary efforts—to collect and disseminate price and quality, more action is needed to ensure these actions are enforced.

Many companies and organizations are creating their own ideas to improve price transparency among consumers. The Annals of Internal Medicine, a publication of the American College of Physicians, for instance, featured an article by Robert Kocher, M.D. and Ezekiel J. Emanuel, M.D., Ph.D, who actively propose the “transparency imperative.” This initiative, which is part of the foundation for a post-ACA healthcare system that achieves better quality and cost control, suggests that all data on price, utilization, and quality of healthcare be made available to the public unless there is a compelling reason not to do so.

Specifically where dental care is concerned,, a simple and free alternative to dental insurance, is also making strides to ensure that all dental procedures are transparent to its members before they book an appointment through its online platform. The service, which provides its dental savings (averaging around 50%) to both insured and uninsured users, also allows its members to comparison-shop for a dentist (also categorized by their Yelp reviews) in and around their area with a satisfaction guarantee. Understanding that price transparency is merely the first step in transforming healthcare, also offers its members negotiated prices with its dentists, adding yet another layer to assist consumer’s in making educated healthcare decisions, while saving them money.

Out are the days of concealed medical prices, and in are the times of paying for quality healthcare. While most of the ACA has already been enacted, we anticipate that 2014 will continue to bring improvements in the transparency of medical costs, which will subsequently leave patients in the drivers seat of their healthcare decisions, and back in control of their wallets.

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