Transparency in Medicine

As defined by The Institute of Medicine (IOM), “healthcare transparency means making available to the public, in a reliable, and understandable manner, information on the health care system’s quality, efficiency and consumer experience with care, which includes price and quality data, so as to influence the behavior of patients, providers, payers, and others to achieve better outcomes (quality and cost of care)”.

The issue of transparency (price) in the healthcare system has become apparent to the public mainly because of impossible to meet deductibles and out of pocket expenses by insurance companies. The misconception of many consumers, is that high deductible plans began with the Obama Administration when the Affordable Care Act got signed into law. The Affordable Care Act (2010) mandated that all were insured or face a tax income penalty. In conjunction, back in 2003, a series of tax incentive provisions were passed into law to promote high deductible insurance plans paired with health savings accounts.

Price transparency in medicine can be both advantageous as well as inauspicious for practices. Patients knowing the cost of procedures before having them performed lessens the likeliness of an awkward conversation between physician and patient or biller and patient. However, posting prices can sometimes confuse patients and bring forth more questions and keep us on the phone for extended periods of time. It would have to be made clear that prices will vary depending on the specific insurance provider and the specific contract negotiated between the facility/physician and insurance provider.

The bottom line: people are asking more questions, they want to know that services being provided are necessary and reasonable in price. Although being transparent with patients often put physicians’ practices under a microscope, it creates trust between physician and patient and empowers them to make informed decisions on medical treatment.

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