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04/19/17

Gag Orders

The continued push for price transparency is a good thing, but requirements on providers must be matched with similar obligations of payers.

Eventually, today’s post will get around to attempting to say something of value, something related to the subject of price transparency, but I have to apologize for a brief digression before we start.

Several states have laws that allow people to carry a concealed weapon.  Most that do require the person to complete a safety class before receiving a permit because, handled improperly, guns are dangerous.  Can we require a similar safety class before people go spouting statistics?  These, too, can be dangerous, and we have some crazy people out there, running around waving their bad stats and worse conclusions.  Someone is going to get their head shot off if we are not more careful.

Yes, I wrote about bad stats supporting bad policy on Monday.  Two data points make a trend.

So, I was doing some reading on pricing transparency (I’ll get to my point, keep your shorts on) from one of the most highly regarded healthcare think tanks in the country and there were some hilarious observations.  I’ll keep their name confidential to protect the guilty.  Here are just two.

‘The cost of health care is expected to rise by more than 85% over the next 20 years.’

Wow, that is huge, a crisis of Biblical proportions.  That is an outrageous…wait…that is about 3.3% a year.  Oh.  85% is far scarier, isn’t it?

‘About half of Americans have tried to find out about the price of health care before getting services.’

Yes, and half apparently did not.  Which is a more telling statement? BTW, I did that math without a calculator.

Sorry, I am snarky this week. 

I guess the point is to beware policy advocates attempting to masquerade as honest data brokers.  Advocacy for a position is fine and it is to be expected that most advocates cherry-pick their data.  I confess to that as well.  But if we are to work our way through this complex mess and find some solutions, a slightly higher level of statistical literacy would be helpful. 

Digression over.

So, the piece leads with this statement: Price transparency might have the single biggest effect in informing the public about health care costs.

OK, I can’t help myself…REALLY?  Sharing information about costs might help people know more about costs?  Brilliant.  What insight.

Digression really over this time.

Look, we are supporters of price transparency, mostly because we trust markets more than the government and markets need information to be as efficient as possible.  Shine the light and let the games begin.

But the authors complain that providers are hiding behind non-disclosure agreements and gag orders in their payer contracts as an excuse to not be more transparent.  Excuse me?  Who put those provisions in the contracts?  You think we asked for them? 

You want transparency?  Fine, bring it on, but make everyone play by the same rules.  If providers are to publish their prices to patients, make the payers also share the rates they are paying everyone.

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ALN

Tim Coan, ALN’s CEO, writes an insightful and witty blog three times a week about a variety of topics relevant to independent physician practices.

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