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'Price Transparency' Only a Beginning

Making information about the cost and quality of health care publicly available is essential for those who purchase and use care. But in her recent invited testimony before Congress, Fund Senior Program Officer Sara R. Collins, Ph.D., also said that while "price transparency is a beginning," it is "unlikely to have a major impact without better information on quality and total bills for the treatment of different acute and chronic conditions."

Speaking before the House Energy and Commerce Committee's Subcommittee on Health on March 15, Collins said that patients' use of information on cost is unlikely on its own to transform health care. Most health care costs are incurred by very sick patients, often under emergency conditions; under these circumstances, it's nearly impossible to shop around for the best physician or hospital. Payers, federal and state governments, accrediting organizations, and professional societies, she argued, are much better positioned to insist on high performance.

To achieve transparency and improve performance in the health care system, Collins and testimony coauthor, Fund President Karen Davis, believe the federal government should take a leadership role in creating a database on costs and quality and encouraging the incorporation of quality and efficiency measures into pay-for-performance systems operated by Medicare, Medicaid, and private insurers. At the same time, "higher patient cost-sharing and high-deductible health plans are the wrong prescription," the authors write, noting that they ultimately place a greater financial burden on the sickest and poorest patients.

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