is unusual in that the prices for services are largely confidential. Several aspects of the health care market make cost information difficult to obtain. These include health care factors such as the fragmented billing of different providers for an episode of care, the difficulty of predicting the services that will be provided during an episode of care, and varying insurance benefit structures, as well as legal factors such as antitrust law, contractual obligations between insurers and providers, and hesitancy to disclose negotiated rates (Government Accountability Office, 2011a).

Additional challenges facing this type of reporting include the common perception that higher-cost care is higher-quality, limited provider competition in some geographic areas, and differences between prices for procedures and overall health care costs (Ginsburg, 2007; Hibbard et al., 2012; Tu and Lauer, 2009). While there is significant interest in overcoming these barriers to improve the transparency of cost information, such transparency initiatives have been implemented in few places, and their effectiveness remains unclear (Government Accountability Office, 2011a). Nonetheless, evidence demonstrates that transparency can focus employer and policy attention on price differences (Tu and Lauer, 2009). Increased penetration of high-deductible health plans also may encourage greater use of reported information, although this will require that the information be available in an understandable format and customizable for a particular patient’s situation.

Conclusion 8-2: Transparency of process, outcome, price, and cost information, both within health care and with patients and the public, has untapped potential to support continuous learning and improvement in patient experience, outcomes, and cost and the delivery of high-value care.

Related findings:

  • Reporting and transparency improve performance in certain circumstances. Following public reporting of pneumonia care measures, for example, rates of compliance rose from 72 percent to 95 percent in 8 years.
  • Reporting and transparency provide clinicians with information they want and need. Results of one initiative indicated that coupling financial incentives with assistance to clinicians in monitoring their practice patterns against those of others decreased spending growth by 2 percent per quarter while improving overall care quality.


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