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Health Insurance Pricing Transparency Could Save $36B Annually

John Commins, for HealthLeaders Media, February 29, 2012

David Shapiro, MD, president of the Ambulatory Surgery Center Association, supports transparency, but says trying to compare prices for healthcare is practically impossible right now because of its inherent complexity.

"I am a physician, and if I seek to purchase healthcare … I have the same problem that a non-physician patient would have trying to determine what that cost would be," Shapiro said.

"You may or may not know what your insurer will pay. You may or may not know what you pay for insurance. Possibly your employer writes the check. So you have huge firewalls between your hard earned money and purchasing healthcare," he said.

"Healthcare is not only the most important service you buy, it is certainly the most expensive and complicated. You mix all those things up and you essentially have the perfect storm and the patient who has the most at stake really has the least input and knowledge of the system," he says.

The study used insurance claims data for employer-sponsored insurance plans to analyze variations in prices nationwide for 300 "shoppable" high-volume elective procedures, such as a mammogram, colonoscopy or MRI. The claims data showed that some prices in some markets were two or three times higher than the median price for the same procedures.

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