The panel “Price Transparency: What It Is and What It Isn’t,” was moderated by Leah Binder from the Leapfrog Group. The panel featured Paul Ginsburg from the Center for Studying Health System change; Bill Kramer from the Pacific Business Group on Health; Dolores Mitchell from the Group Insurance Commission of Massachusetts; and John Santa from the Consumer Reports Health Rating Center.

Several of the panelists used the title of this session as their starting point for discussing the value of price transparency. They explained that price transparency is a tool for revealing many organizations’ pricing information to their colleagues, peers and customers across the health care system. Perhaps the most obvious group that could benefit from price transparency is patients: once patients can see out-of-pocket costs, they will have the option to choose those with the lowest cost. Besides patients, however, many other groups are lacking the price data they need. For instance, payers could use increased price transparency to select cost-efficient providers for their plans, and employers in turn could use data about plans when managing employee benefits.

However, while the panelists acknowledged that price transparency is an essential tool for payment reform, they also were quick to point out that it is not sufficient for health reform, particularly in its current state. Dr. Ginsburg noted that different audiences have different data needs and interests. For instance, if price data is directed at patients, it should report out-of-pocket costs, rather than physician charges, in order to be most relevant to this audience. Likewise, Dr. Kramer emphasized that price data should include all costs associated with a procedure, including additional services beyond the primary procedure. While several panelists offered examples of successful price transparency initiatives, their comments revealed the challenges behind creating tools that are truly meaningful to their target audiences.

Although this panel’s title referred to price transparency, it also became clear that the more interesting and complex issue at hand is value transparency, which considers quality as well as price. Dr. Santa explained that Americans are most interested in learning about value, and this is likely true for most other players in health care: ultimately, we all want to find the ideal intersection of price and quality. Unfortunately, the panelists agreed that value is even more difficult to identify and measure than price. Unlike price data—which exists but is often concealed—quality data is much more difficult to generate because it takes into account so many factors, including clinical outcomes as well as patient-reported outcomes. Dr. Mitchell pointed out that even after we have identified the factors that make up quality, the quest for “statistical purity” will slow down the reporting of these figures.

A key takeaway from the session was that the path toward price and value transparency will not be an easy one. However, the panelists expressed a hope that we can leverage policy and popular demand in order to bring this issue the attention it deserves.

By: Lauren Edmundson, Research Assistant, AcademyHealth