Not surprisingly, Americans continue to demand transparency in their health care costs, especially as many struggle to find affordable and affordable treatment options.
And why wouldn’t they? In this country, our largest systems work best when the default expectation is transparency—from our criminal justice system to our publicly traded companies and our elections, it is essential to their functionality that the general public is informed as much as possible. -a lot of information reasonably to be entitled.
There are common sense limitations: who you vote for is a private individual and corporations don’t have to give up their proprietary “secret sauce,” but the expectation is that the public should have visibility into the institutions that shape their lives.
So as we look at health care, it’s time to recognize that legislative transparency efforts are hitting a wall and determine what else we have in our toolkit to achieve this noble goal.
It’s time for leaders to embrace technology-based approaches to collaboration
Health care spending topped $4.3 trillion in 2021 and is expected to grow to $6.8 trillion by 2030, according to projections by Centers for Medicare and Medicaid Services.
As prices continue to rise, policymakers and healthcare industry leaders must pave the way for new, transformative technologies to achieve greater transparency and collaboration in the healthcare system. Until now, current drug price transparency laws have been limited in terms of who is required to share data and how, creating gaps where consumers can see prices.
Ann analysis from the Leonard D. Schaefer Center for Health Policy and Economics at the University of Southern California examined 166 recently enacted drug pricing laws and found that most legislation with a transparency component was narrowly written and did not require all stakeholders to share price data.
The researchers concluded that these laws had limited impact and did not provide full transparency throughout the distribution system, despite the “enormous resources expended to enforce them.”
Hospitals that recently faced new transparency rules from CMS are operating in the “wrong system,” according to MedCity News aarticle. One study showed less than six percent of hospitals were able to fully comply with the new price transparency rules. Many hospitals simply do not have the technology infrastructure to meet the demands.
To overcome these shortcomings, healthcare organizations can turn to innovative technologies that can make complex data sets more manageable and build trust on a shared digital foundation.
The plan to increase transparency is already a focus in the 340B drug pricing program, where some stakeholder groups are seeing the benefit and clarity of working with a shared data set and open collaboration more.
Work together to promote greater visibility
Using technology can simplify the process and encourage collaboration between all parties, from drug manufacturers to hospitals.
Legislators should consider legislation that provides more comprehensive transparency in healthcare sectors while enabling technological innovation that can simplify data sharing for stakeholders. Fair and multilateral platforms facilitate an environment where all parties are on an equal footing and can seamlessly share data, ensuring that laws are implemented effectively and work as intended.
While all transparency legislation should encourage greater sharing of pricing data, we must be sure to allow common sense limits. Protected health information (PHI) must continue to be aggressively secured by all stakeholders and technology partners.
Any new legislation should also protect interested parties from suffering any retaliation once all the information becomes public. For example, protected network health care providers that use the 340B drug pricing program should not face discrimination in reimbursement from payers.
Holistic solutions for health care cost transparency and drug pricing must create access to key information Americans expect about the institutions they depend on. Fostering technology solutions that can connect people to key data should be a fundamental part of this approach. By making room for new technologies, we open the door to systemic change for the better.
To stay one step ahead
As our technology and healthcare needs continue to evolve, it is imperative that any transparency solutions we implement today are flexible enough to meet the challenges of tomorrow. Many aspects of the healthcare system are siled and do not consider how to easily share information across multiple platforms and sectors.
By simplifying the process and facilitating collaboration, we can improve broad transparency in the health care system and identify solutions that can help meaningfully address rising health care costs.
We can provide the reasonable transparency Americans deserve.
For legislators, this means passing legislation that can create fair and systematic visibility. For those in health technology, this means creating technology ecosystems that work with shared data to bring all stakeholders to the table.
Photo: Alexander Hruts, Getty Images