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The Goodman Institute Health Blog

How to Create Transparent Pricing

Posted on March 3, 2023March 3, 2023 by John C. Goodman

James Capretta and David Bernstein (AEI) recommend these changes for CMS:

  1. Require transparent, “all in” prices for standardized services required to fully complete a clinical intervention.
  2. Require all providers to participate in this bundled pricing system.
  3. The prices posted for these services should be “walk up” prices available to all patients, irrespective of their insurance status.
  4. Require insurers to make available to their enrollees the dollar value of their median out-of-network rates, so that patients could then apply those payments from their insurers to any provider of their choosing.
  5. An additional option would be to allow patients to place the dollars saved by selecting lower-priced providers into tax-free health savings accounts (HSAs) for future use.

They add that, “Shopping for care based on price is not possible in many circumstances, but it could apply to about 40% percent of all spending on medical care.”

1 thought on “How to Create Transparent Pricing”

  1. Bob Hertz says:
    March 4, 2023 at 2:42 pm

    And I thought I was guilty of working from unrealistic wish lists!

    Captretta and Bernstein are very intelligent, but quite utopian. Their prescriptions would destroy the whole network pricing scheme, which may be a good thing but would be wildly resisted.

    I would want to see just how many procedures the medical community would allow to be put into standardized bundles. My hunch is that the number would be very, very low.

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