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Get Ready for Price Transparency

Philip Betbeze, for HealthLeaders Media, November 30, 2012

But CPR doesn't just ask for transparency, it is ready to help those who are interested in pursuing it. CPR has model contract provisions that would allow for transparency, for example, and it's currently holding quarterly meetings with the four largest national health plans on progress toward price transparency.

"Every quarter we check in with them on their progress on in-house tools and what proportion of providers are suppressing price information," Delbanco says.

After a year of such discussions, she says significant progress has been made on transparency tools.

"We have seen some of the health plans becoming more flexible, but there are some holdouts," she says. "We're hoping this attention to what employers and consumers need will convince those remaining holdouts."

If not, pressure will also come from elsewhere. Though Delbanco says CPR has not modeled the shift, the creation of state-level insurance exchanges under the Patient Protection and Affordable Care Act should create a more structured marketplace for consumers to shop for health plans. She contends that health plans that support strong tools to help consumers be good stewards of their own dollars will have a competitive advantage.

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2 comments on "Get Ready for Price Transparency"


Sara McFarland (12/3/2012 at 10:57 AM)
We agree wholeheartedly that transparency is necessary and it is not on the horizon anymore, it is already here. Patients need to know where they can go for transparency and get accurate pricing and quality grades, personalized to their needs. This is why we created our site, to remove the guess work and time wasted calling around to practices on the search for pricing. Additionally, even if a patient does get a quote over the phone, who is to say that is the price they will end up paying? We've removed that shadow of doubt with online payments and scheduling all online like Hotels.com. It's the future of health care and the bright side? Providers ARE buying into this. When they see the writing on the wall, they will fall in line because they will see that it is beneficial to them as well to be futuristic when it comes to their practice.

Dan Prince (11/30/2012 at 4:09 PM)
If we ever truly want "consumer-driven" healthcare, having transparent quality AND pricing information is imperative!