Commentary: Consumers deserve more transparency in health care pricing

One of the concerns that I consistently hear about when I talk to constituents is the rising cost of health care in Delaware and across the nation.

Earlier this summer, I had the opportunity to attend a press event in Washington, D.C., during which President Trump signed an Executive Order (EO) that will help provide consumers with greater transparency as it relates to health care services and pricing.

The Executive Order on Improving Price and Quality Transparency in American Healthcare to Put Patients First was signed on June 24 at the White House. The Executive Order states that patients must know the price and quality of a good or service in advance of a purchase in order to make a fully informed decision.

Unfortunately, though, “patients often lack both access to useful price and quality information and the incentives to find low-cost, high-quality care,” according to the EO. The Executive Order attributes these issues to the “predominant role that third-party payers and Government programs play in the American healthcare system.”

The EO further states that “Opaque pricing structures may benefit powerful special interest groups, such as large hospital systems and insurance companies, but they generally leave patients and taxpayers worse off than would a more transparent system.”

Rep. Tim Dukes

As with any other good or service that consumers are planning to purchase, they should be able to shop for the best quality and price. Healthcare decisions by you and your family should be made in the same manner. “Shoppable” services are those that patients can research and compare by price and quality and, reportedly, they make up a significant portion of the healthcare market. In fact, the June 2019 Executive Order states that, according to a study, the ability of patients to price-shop imaging services resulted in a per-service savings of up to approximately 19 percent.

Greater transparency within the health care market by allowing consumers to have as much advance information as possible will also reduce the amount of “surprise billing.” This practice occurs when patients receive unexpected bills at highly inflated prices from out-of-network providers that they had no opportunity to select in advance.

As part of the president’s order, a few actionable items were to be implemented, including the following directives:

  1. Hospitals will be required to publicly post standard charge information for common or shoppable items and services in an easy-to-understand, consumer-friendly format, allowing patients to compare prices across hospitals.
  2. Comments will be solicited on a proposal to require health care providers, health insurance issuers, and self-insured group health plans to provide or facilitate access to information about expected out-of-pocket costs for items or services to patients before they receive care.
  3. A report shall be issued describing the manners in which the federal government or the private sector are impeding healthcare price and quality transparency for patients, and providing recommendations for eliminating these impediments in a way that promotes competition.
  4. Empower patients by giving them more control over their healthcare resources, including by expanding patients’ ability to select high-deductible health plans that can be used alongside a health savings account for medical care that helps maintain health status for individuals with chronic conditions.

It was an honor to attend this event in our nation’s capital to stand with the president and help support an initiative that I believe can make a world of difference for patients and healthcare consumers.

Implementing greater transparency in pricing and the quality of services should not be delayed any further and I will do all I can at the state level to ensure Delaware’s healthcare industry models this national endeavor.

Rep. Tim Dukes, a Republican, represents the 40th District, which includes the areas of Laurel, Delmar, and Bethel, in the Delaware House of Representatives.

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