Introduction: Since the White House released an executive order to help improve price transparency for healthcare consumers, industry leaders have been discussing and preparing for the final rule. This post is the second in a three-part series sharing insights from an executive panel that included Millicent Cox-Edwards, Senior Director, Kaiser-Permanente; Alexander Domaszewicz, Principal and Senior Consultant, Mercer; Dr. Jeffrey Guy, Vice President, Clinical Services Group, HCA Healthcare; and Lilly Stairs, Patient Advocate and Head of Client Relations, Savvy Cooperative. Statements have been edited for clarity and length.
The executive order proposes policies that are designed to help patients make fully informed decisions about their healthcare and protect patients from surprise billing. While most people would agree with these goals, it is important to anticipate what some potentially unintended consequences this rule might bring. To that end, we asked panelists: What are some of the potentially unintended consequences of price transparency the industry should avoid?
Price transparency is not a panacea
Lilly Stairs (Patient Advocate): It could cause some patients to avoid getting healthcare. Also, remember that price transparency is not a panacea. Us saying “prices are transparent, we’ve fixed it” does not mean that our work is done. Price transparency should be a jumping-off point to address deeper-rooted problems – knowing what to do when patients can’t afford a service, making sure that we respect that patient-doctor relationship and ensuring that the patient gets healthy and stays healthy.
Need to address patient engagement and coordination
Dr. Jeffrey Guy (Provider): There is recognition in the industry that patients need to engage with their healthcare differently. Rather than just create transparency, people are calling for improvement around communication, decreasing fragmented care, better coordination and improved efficiency.
Don’t overlook non-traditional venues of care
Sander Domaszewicz (Employer): We might get what we’re asking for, and the outcomes may not be what we want. The workforce doesn’t want surprises. They want to know what package of services their doctor recommends and the financial implications. Like shopping for gas, where it’s clearly posted on every corner, or getting a clear, concise pre-estimate for auto repairs. The reality is, as we move towards transparency, there are more services willing to offer this in healthcare; the retail clinic market and telemedicine both are expanding transparent services into primary and chronic care, and they will set a high transparency bar for other providers. We also have to try and keep care from fragmenting, which could be bad for their health. We don’t want to be penny wise and pound foolish.
Patient concerns about affordability becoming a barrier
Millicent Cox-Edwards (Health Plan/Provider): One of the primary unintended consequences is more confusion and concerns about affordability. Our approach at Kaiser-Permanente is to always provide information about how members can get help paying for care when we advise them of costs. Help might be a payment plan or medical financial assistance for those who qualify. For all patients who may have concerns about affordability, we’re trying to provide an environment where we can have a dialogue about the care they need and how to get financial help, if cost is prohibitive for them.
Read other posts in this series: