Friday, June 7, 2019

Price transparency proposals raise thorny questions


Samantha Liss June 7, 2019
A longtime hospital CEO in New Jersey is calling for price transparency — even advocating for disclosure of negotiated prices between hospitals and insurers — as the industry pushes back against attempts by the Trump administration to force highly secretive rates out into the open.
"The current healthcare market is a complex system of secret deals and discounts between insurance companies and healthcare providers," Michael Maron, CEO of Holy Name Medical Center in Teaneck, New Jersey — located about 14 miles outside of Manhattan — wrote recently in a letter responding to proposed regulations that include tackling pricing issues.  
"For decades, insurance companies and powerful provider systems have succeeded in keeping their negotiated rates veiled from public view using non-disclosure agreements and restrictive contractual gag clauses," he wrote.
Maron's ideas conflict with powerful lobbying groups representing major healthcare institutions and insurance companies.
The American Hospital Association, of which Maron is a member, said the proposed approach of releasing negotiated rates "misses the mark" adding price is not the sole factor patients consider when deciding where to receive care.
"Disclosing negotiated rates between insurers and hospitals could undermine the choices available in the private market," Tom Nickels, executive vice president of AHA, said in a statement. AHA represents nearly 80% of the nation's hospitals and lobbies on their behalf.
The lobbying group representing the nation's insurance companies also balked at the transparency proposal, arguing the disclosure could harm competition and lead to higher prices.
"If every contract and every negotiated rate were public, no doctor or hospital would want to be paid the lowest rate — they would all be motivated to demand higher payments. And health care costs would rise for all Americans as a result," America's Health Insurance Plans CEO Matt Eyles said in a statement.
The push for pricing transparency comes as more Americans rely on high-deductible health plans for their insurance coverage. Those plans can result in consumers paying for a greater portion of their own healthcare.   
Consumer spending has increased dramatically over the past two decades. In 1997, out-of-pocket spending was $589 per capita, growing to $1,124 in 2017, according to a Kaiser Family Foundation analysis of National Health Expenditure data.
The top concern for Americans continues to be healthcare as they fret over affordability and access to care, a recent Gallup Poll shows. Americans worry more about healthcare than crime or the economy.
"As healthcare becomes more expensive and more unaffordable, the demands for price transparency are only going to increase," Steve Wojcik, vice president of public policy for the National Business Group on Health, told Healthcare Dive. NBGH does not support disclosing prices negotiated across all plans. Instead, NBGH supports patients having access to their "out-of-pocket expenses and total plan expenses for providers and services for the specific coverage they have," he said.

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