Provision of societal benefits one goal of price

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Provision of Societal Benefits20One goal of price transparency is to make the healthcare system more efficient, encouraging providers to focus on maximizing the efficiency of their operations and reducing their internal cost structure so they can better compete on price In some instances, however, providers offer services (e g , a Level I trauma center) or programs (e g , a strong teaching and research mission) or serve low-income, indigent, or rural populations to address community or societal needs but may not produce a profit or positive margin, regardless of improved efficiencies 18, 19As noted in one analysis of this problem, “until the political system is willing to level the playing field by explicitly paying for under- and unfunded services, market changes such as price transparency and specialization, although beneficial in their own right, could have severe negative consequences ”This is not an argument against price transparency, but a reminder that any system of price transparency should be implemented with full awareness of these potential consequences, which may require policy solutions to ensure the continued provision of services such as those described above Policy Considerations
PRICE TR ANSPARENCY IN HEALTH CARE 13Recommendations for Price Transparency FrameworksWhile all care purchasers share a common need for greater price transparency, the framework for different care purchasers varies according to such factors as the most important information needed and the source of that information This section outlines the task force’s recommendations for price transparency frameworks for different groups of care purchasers Price Transparency for PatientsRecommendation 1. Because health plans will, in most instances, have the most accurate data on prices for their members, they should serve as the principal source of price information for their members. As noted earlier in this report, many health plans have already developed or are in the process of developing web-based or telephonic transparency tools for their members These tools have the potential to benefit both patients and health plans, providing patients with needed information while strengthening the health plan’s value to its members Employers with self-funded health plans have the option of working with health plans (which often serve as third-party administrators for self-funded plans) or other vendors in developing transparency tools for insured employees and their dependents Recommendation 2. Health plans and other suppliers of price information should innovate with different frameworks for communicating price information to insured patients.Health plans and other transparency tool vendors should be encouraged to continue to innovate with different transparency frameworks to see which are the most effective in communicating with patients Recommendation 3. Transparency tools for insured patients should include some essential elements of price information.Building on the features of existing price transparency tools,

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