In recent years, healthcare pricing has come under much scrutiny. Calls for price transparency have been made, loudly and clearly. Discounting prices to some recipients or payers occur, but how and why does this happen? Patients with insurance typically pay an insurance-negotiated discounted rate, while patients without insurance can be asked to pay the full amount that is charged by the provider or facility. Why can’t you simply look on each provider’s website to see the exact cost of your office visit, or your x-ray? With the many methods of cost-setting available to us as healthcare managers, we see how there is a high degree of variability in the amount charged per service from person to person, and state to state. In moving towards either voluntary or state-mandated transparency in healthcare pricing, we consider the following Case assignment questions.
Case Assignment
After completing the required background readings, please complete the following questions:
1. Describe the recent scrutiny of the methods of healthcare pricing. Is this scrutiny justified, or unjustified?
2. What can healthcare managers do to be best prepared for increasing future calls for transparency (either voluntary, or state-mandated)?
3. How have state transparency laws affected healthcare pricing in your home state, or state of current residency? Can you locate the exact costs of healthcare services you or your family may need in the near future?
4. How is cost-shifting implemented within the healthcare settings? Do you believe this ethical?