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HL20: Steven Sonenreich—Talking Transparency

Philip Betbeze, for HealthLeaders Media, January 9, 2014

The problem was and is that Sonenreich is not allowed to do what he promised—at least, not exactly.

Why? Contracts with insurers almost always preclude the release of this data on competitive grounds that some regard as dubious.

"The majority of insurers are marketing organizations that want to have the broadest network possible," he says. "They should do more to manage expense for policyholders in order to hold down the cost of health insurance."

Insurers argue that allowing hospitals to know what each other are getting from the insurer puts the insurer at a disadvantage. Maybe so, but conveniently, that custom also obscures whether the insurance company is in fact performing one of its key roles as an arbiter of prices for its customers—employees and employers. It dulls the incentive for the insurer to drive the best bargain, and it's yet another instance of opacity in an industry that is too unsafe and too expensive. Most agree that patients and employers would benefit from healthcare cost transparency as it relates to reimbursement rates, yet it's contractually forbidden.

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