Contact Josh Archambault (617) 645-7679 (firstname.lastname@example.org) or
Barbara Anthony (857) 998-0273 (email@example.com)
BOSTON – With state government officials seeking alternatives to an initiative petition that would implement healthcare price controls, Pioneer Institute will help form a new working group on healthcare price transparency to explore opportunities to improve patients’ access to crucial information about the cost of their medical procedures, engage them in health care decision-making, and improve healthcare value.
Years of research from the Office of the Attorney General, CHIA (Center for Health Information and Analysis) and the Health Policy Commission have made it clear that unwarranted price variations in the Massachusetts healthcare market present significant barriers to cost containment. More recent Pioneer research has shown that even with the most robust healthcare transparency law in the country, basic price information is still hard to come by, and consumers are not effectively encouraged to use that information. Thus consumers are ill-equipped to make value-based decisions or to even weigh unwarranted price variations among providers.
The newly formed Transparency Working Group will explore existing and additional transparency options for the different, and distinct, markets that exist in the state.
- The individual and small business market;
- The Group Insurance Commission (GIC), for state and some local employees;
- Health Connector and MassHealth plans, and
- Large employer sponsored plans
As regards to the federally-regulated self-insured market for larger companies, the working group will consider educational opportunities to promote value shopping by employees and active use of price transparency.
“An engaged consumer seems to be the missing ingredient to tackle unwarranted price variation,” says Pioneer Senior Fellow Josh Archambault. “In a world of higher deductibles, higher co-pays and hospital consolidation, patients are being squeezed. We need to create tools and incentives to reward patients seeking value. Done well, patient-centered care could emerge and organically transform our healthcare system.”
“Transparency is an important tool in tackling costs in healthcare. But as our past research has shown, there is still lots of work to do to increase the availability of basic pricing and cost information to consumers,” says Barbara Anthony also a Pioneer Senior Fellow. “Our hope is that this working group will be a thoughtful and constructive voice for the next steps that are needed in healthcare price and quality transparency for consumers.”
The working group will seek ideas and input from numerous stakeholders in healthcare, and will focus on transparency related options that can be adopted by both state government and private companies.
Anthony, a well-known consumer advocate and former Undersecretary for Consumer Affairs and Business Regulation in the Patrick Administration, has authored a series of surveys on the difficulty consumers have in obtaining pricing information from hospitals and medical practices in Massachusetts and in six major US city regions across the country: “Massachusetts Hospitals Weak on Transparency,” “Bay State specialists and Dentists Get Mixed Reviews on Price Transparency,” and “Healthcare Prices for Common Procedures Are Hard for Customers to Obtain: Survey finds hospitals not prepared to give price information to consumers.”
In Pioneer’s most recent healthcare report, “Are Drug Prices Driving Healthcare Cost Growth?,”Pioneer Executive Director Jim Stergios urged that instead of legislative efforts requiring pharmaceutical companies to disclose proprietary information, the state and the healthcare industry should provide clearer pricing data for pharmaceuticals.
A December 2015 Pioneer report by Pioneer Research Assistant Matthew Blackbourn, “What Will U.S. Households Pay for Health Care in the Future,”found that healthcare costs for the average U.S. family could increase from $8,500 annually to as high as $18,000 by 2025 – equivalent to up to 27 percent of household income by 2025. A 2012 Pioneer report, “Consumer Driven Health Care: A New Agenda for Cost Control in Massachusetts,” authored by Dr. Amy Lischko, a former Pioneer Senior Fellow, found that such plans have been shown to reduce health care spending, engage consumers and improve health more than traditional plans. “So, while consumers are increasingly being asked to assume greater responsibility for their health care costs, the tools and incentives they need to make good decisions are woefully absent,” added Anthony.
On Thursday, May 26th, Pioneer will hold an event, “How to Save in Healthcare and Pay Patients in the Process,” exploring a program in place for New Hampshire state employees that provides cash incentives, price transparency and quality information, to engage patients and save millions of dollars. In just two years, the program has saved $12 million and resulted in over $1 million in incentive payments to employees.