Hospital Price Transparency – Not a Cure for the Disease

Transparency has revealed just how absurd the current contracting process is, and has in many ways caused more confusion and obfuscation……………….Costs could very likely rise in many markets as systems learn about higher prices being charged by their competitors – the definition of ‘unintended consequence………….

Centivo’s Alan Cohen: Hospital Price Transparency – Not a Cure for the DiseaseMyHealthGuide Source: Bruce Lee, Centivo, 7/27/2021

As you well know, the hospital price transparency requirements that kicked in as of January 1, 2021 have generated a great deal of interest and hope among those who believe in the need to radically transform the byzantine pricing/payment structures found within the US healthcare system. Unfortunately, according to Centivo’s Chief Product Officer Alan Cohen (a 30+ year career executive in the health insurance/benefits industry), hospital price transparency, at least in its current form, will not drive significant transformation. Please reach out to me if you would like to discuss why with Alan.

Please Note – This does not in any way imply that here at Centivo we are “anti-transparency.” In fact, radical transparency with our clients (all Centivo fees disclosed to the penny, all other funds passed through to client) and members (simple, easy to understand copay schedule) are foundational to our core health plan.

Background:

The reasons why hospital price transparency in its current state will not drive true transformation are many, but the central issue is that ‘price transparency’ is a symptom, not the disease, plaguing US healthcare. Why not a cure? Alan’s point of view includes:

  • Transparency has revealed just how absurd the current contracting process is, and has in many ways caused more confusion and obfuscation, not less (case in point, read this)
  • Compliance is low and incomplete, to put it mildly
  • Costs could very likely rise in many markets as systems learn about higher prices being charged by their competitors – the definition of ‘unintended consequence’
  • According to the Kaiser Family Foundation, 20% of consumers drive 82% of healthcare spending – and Out-of-Pocket maximums can be reached quickly by this group (are they even ‘consumers’ at this point?)
  • Transparency may have the biggest impact on lowering the price for healthcare services that were already low to begin with – in other words, non-transformational

The true ‘disease’ is the continued use by the payer community of high-cost systems and providers whose costs do not correlate to better health outcomes than lower cost providers. Centivo and other health plan disruptors are focused on building networks for self-funded employers that directly engage and support leading providers of value-based care. Results have been nothing short of remarkable – learn more here.

About Centivo

Centivo is a new type of health plan anchored around leading providers of value-based care. Centivo saves self-funded employers 15 percent or more compared to traditional insurance carriers and is easy to use for employers and employees. Our mission is to bring lower cost, higher quality healthcare to the millions of working Americans who struggle to pay their healthcare bills. With Centivo, employers can offer their employees affordable and predictable costs, a high-tech member experience, exceptional service, and a range of benefit options including both proprietary primary care-centered ACO models as well as traditional networks. Contact Bruce Lee at bruce.lee@centivo.com and visit centivo.com.

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