Transparency of Health Costs

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 The Institute of Medicine (IOM) defines healthcare transparency as making information

about the quality, efficiency, and consumer experience with care available to the public in a

reliable and understandable manner, including price and quality data, in order to influence the

behavior of patients, providers, payers, and others in order to achieve better results (quality and

cost of care).

It is the practice of health insurance companies to make its subscribers aware of the

prices that they have negotiated with physicians and hospitals, as well as government

organizations releasing information about the national average cost of health-care services.

Transparency providers are health-care providers who openly disclose their regular rates for

certain health-care services, which may vary depending on their contracts and contacts with

different payers. These providers are referred to as "transparency providers" in the industry.

Access to transparent healthcare information is helpful to a wide range of stakeholders,

including patients and customers, employers and buyers, health plans, health-care providers, and

legislators, among others. Patients and their families can make educated judgments when picking

a health insurance plan, a hospital, or a professional practice, as well as when evaluating

alternative therapies, based on the knowledge they have acquired. Among other things, there is

concern about the effectiveness and frequency with which patients use such information, as well

as the most effective means of delivering such information to the broader public. Greater

transparency in health-care delivery may result in patients having greater confidence in their

doctor-patient relationship, as well as greater trust in health-care organizations as a result of

increased transparency in health-care delivery. Higher levels of transparency, increased

competition, and/or the availability of clinical benchmarks may all contribute to the overall

improvement of quality, safety, and efficiency across the entire healthcare system.
 As described by the dictionary, transparency is "characterized by the openness or

accessibility of information, particularly on corporate practices," and it is also "clearly

intelligible." Transparency is most typically related with the public disclosure of information and

the management of procedures in the healthcare industry. As defined by the World Health

Organization, information about the quality, efficiency, and consumer experience with care, as

well as pricing and quality statistics, should be made available to the public in a trustworthy and

understandable manner to ensure that the public can make informed decisions..

Transparent healthcare information, which includes the complete spectrum of

stakeholders, has the ability to attract the attention of individuals who utilize healthcare services,

as well as employers, health insurance companies, providers, and legislators. A recent

Commonwealth Fund study of healthcare thought leaders concluded that "transparency in

healthcare is essential for pushing the United States toward a higher performing health care

system." An increase in healthcare transparency has the potential to deliver a number of benefits,

according to the research, including the ones stated below:

Due to increased access to information, the number of patient-physician contacts is

expected to rise, and public confidence in health-care systems as a whole is expected to improve

as a result.

In part as a result of increased competition or increased availability of clinical

benchmarks, among other factors, the overall quality, safety, and efficacy of the healthcare

system have all improved significantly.

With respect to healthcare transparency, the purpose of this paper is to provide a broad

overview before delving into specific issues such as price transparency and clinical performance
transparency in greater depth—with a particular emphasis on issues relating to physicians and

their relationships with healthcare patients/consumers as a result of their professional practice.

When it comes to this subset of transparency, this paper presents an overview of the most

relevant topics and actions associated with it. It also examines current ACP policies and makes

new policy recommendations where necessary.

References:

1. Haque, W., Ahmadzada, M., Allahrakha, H., Haque, E., & Hsiehchen, D. (2021).

Transparency, Accessibility, and Variability of US Hospital Price Data. JAMA Network

Open, 4(5), e2110109-e2110109.

2. Henderson, M., & Mouslim, M. C. (2021). Low compliance from big hospitals on CMS’s

hospital price transparency rule. Health Affairs Blog.

3. Herb, J., Williams, B., & Stitzenberg, K. (2021). Hospital Price Transparency Rules are

Inadequate to Inform Patients Needing Major Gastrointestinal Cancer Operations. Annals of

Surgical Oncology, 1-2.