Abstract:
This paper describes hospital, insurance, and pharmaceutical price transparency policies and applications in the United States and in selected countries around the world. Many of these policies apply to self-insured employers. So far, the experience in the United States and elsewhere is clear that federal and state price transparency regulations have had little impact on whether employees or dependents search for low-cost or high-quality providers or on the cost and quality of their health care. This is because of weak regulatory oversight, conflicting federal and state reporting requirements, and few economic incentives for providers and insurance companies to supply easily readable or analyzable price information. However, price transparency requirements are here to stay. This paper therefore offers several recommendations to maximize the utility of price transparency tools provided for employees and other insureds, by their employers, providers, commercial insurance carriers, or technology firms. From a policy perspective, coupling reporting requirements with clearer technological guidance and much stronger regulatory oversight would increase the utility of price transparency efforts. For individual employers, the impact of price transparency efforts may increase by coupling price transparency tools with health plan network and design strategies, behavioral economic nudges, and programs designed to improve health, well-being, and quality of care. Many program vendor partners, consultants, and actuarial, technology, and research firms can help make these efforts useful.
摘要:
本文介绍了医院,保险,以及美国和世界某些国家的药品价格透明度政策和应用。其中许多政策适用于自我保险的雇主。到目前为止,美国和其他地方的经验表明,联邦和州的价格透明度法规对雇员或家属是否寻找低成本或高质量的医疗服务提供者或对其医疗费用和质量影响不大.这是因为监管监管不力,矛盾的联邦和州报告要求,对于提供者和保险公司提供易于阅读或可分析的价格信息的经济激励措施很少。然而,价格透明度要求将保持不变。因此,本文提出了一些建议,以最大限度地发挥为员工和其他被保险人提供的价格透明度工具的效用。他们的雇主,提供者,商业保险承运人,或者技术公司。从政策的角度来看,将报告要求与更清晰的技术指导和更强大的监管监督相结合,将增加价格透明度工作的效用。对于个人雇主来说,通过将价格透明度工具与健康计划网络和设计策略相结合,价格透明度的影响可能会增加,行为经济推动,以及旨在改善健康的计划,幸福,和护理质量。许多程序供应商合作伙伴,顾问,和精算,技术,和研究公司可以帮助使这些努力有用。