Why Your Access Strategy Demands Pricing Transparency

By Nicholas Malenka, MHA, GE Healthcare Partners

Price underpins the basic economics of an efficient market, which is one of the reasons healthcare costs exceed 17 percent of the U.S. gross domestic product. Lawmakers recognize this fact and continue to undertake legislative efforts to increase price transparency in the U.S. health system. Any national effort to improve transparency would put pressure on a health system’s market share because it would fundamentally change the way consumers choose their providers. Healthcare leaders are left to wonder how their organizations should prepare for this new world of increasing price transparency.

Lawmakers, managed care payers, and healthcare institutions are engaged in a tug-of-war over disclosing the costs of care. Healthcare trade organizations and lobbying groups have demonstrated repeatedly that they can influence legislation. For example, the industry challenged Ohio’s Healthcare Price Transparency Law and has successfully delayed its implementation effective date. When and if the law is implemented, it will require that providers “give patients a ‘good faith’ estimate of what non-emergency services would cost individuals after insurance before they commenced treatment.”a It’s easy to imagine how patients might carefully evaluate the value of receiving certain care if all hospitals had to disclose anticipated costs prior to providing the service. 

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