https://www.wsj.com/articles/trump-administration-price-transparency-rule-covering-hospitals-upheld-11592945973
I think this is probably a good thing for helping healthcare prices to come down? Anything that reduces the power of insurance companies is probably good too. That probably won’t happen though unless someone like Bernie becomes president
Why does everyone assume that insurance companies are the problem
The providers are a big cause of the issue, including doctor pay. What they charge and what they pay their doctors is multiples of any other country... insurers are just the piggy bank getting screwed, that try to protect their members from the gouging.
Chief
It’s just as profit driven as any other company - the difference is that they’re in the shadows. Nobody understands them or what they do, whereas it’s easy to blame the big, bad insurance companies.
We’re in a world right know where PE is aggressively buying up healthcare staffing companies and Medicare Advantage- focused hospital providers and focusing on “efficiencies” and “optimizing value” - my girlfriends works in PE - the stories she tells me are pretty ruthless.
Any healthcare consultants who can help weigh in? Not familiar with the industry but all I know is what I pay is too damn high. Although I’m sure this may hurt doctors’ pay which isn’t great
Chief
About 5 years ago I was a product manager for a company that had an internal price transparency tool that let hospital administrators compare prices and patient outcomes (I wasn't the PM for that particular product) at their hospital, hospitals with similar patient demographics, and at all hospitals across the nation.
At the time, hospitals often didn't even have the data themselves to put two and two together.
I got to tag along for the pilot hospital implementation of that product and it was jaw dropping for them. The pilot department was the surgery department and the client product champion was a knee surgeon. He was blown away that his preferred product for total knee replacements was something like 3x more expensive than the industry leader for best patient outcomes, and had way worse patient outcomes, too.
When they started tracking all the other supplies, etc, used in a total knee replacement, that pilot hospital discovered they were paying about 3.5x more for everything that went into a total knee replacement than what had the best patient outcomes, which directly impacted their patient pricing.
If some enterprising company will be able to take the new pricing transparency data and cross reference that to proprietary patient outcome data and make a consumer facing portal, that could be a game changer.
Industry term for pricing information is “competitive edge”. Transparency makes the field fairer. It is a good thing, but it’s nowhere near enough to control healthcare costs.