Perspective: Hitting the right mark on transparency
On Monday, President Trump signed an executive order aimed at promoting health care price and quality transparency. The AHA appreciates the Administration’s efforts to promote health care transparency on price and quality, and strongly supports equipping patients with useful and meaningful information they need to make informed decisions about their care and its cost.
Hospitals and health systems are committed to helping patients navigate their health benefits. Most often, hospitals have in-person counselors to help patients understand their coverage and evaluate any relevant financial assistance options. More and more, hospitals also are developing web-based tools so that patients can easily search for this information online.
At the same time, as a practical matter, in addition to cost and quality, consumers base their health care decisions on recommendations from their physicians and availability of specialized services, among other factors. Of course, consumers can’t shop around for services in an emergency, and they don’t look at price alone when it comes to seeking the highest quality care for themselves or loved ones. Moreover, consumers say they are most interested in what their out-of-pocket costs for care will be, what is covered by their health plan, which providers are in their networks and what their health plan’s cost-sharing obligations are in terms of their deductible and coinsurance.
Meanwhile, economists and analysts have suggested that publicly posting certain information, such as privately negotiated rates, could, in fact, undermine the competitive forces of private market dynamics with unintended consequences such as insurers coordinating to disadvantage providers and consumers. And the Federal Trade Commission has counseled against disclosure of health plan terms and urged that transparency be limited to “predicted out-of-pocket expenses, co-pays, and quality and performance comparisons of plans or providers.”
On quality, the AHA stands ready to continue to work with the Administration to identify those measures that will best inform patients about their care choices, as well as align measure requirements across federal programs to best incentivize performance improvements.
When the federal government and America’s hospitals and health systems work together, we can make a real difference for patients. We can give consumers the information they need to better navigate their care. And we can advance health in America.