James Capretta and David Bernstein (AEI) recommend these changes for CMS:
- Require transparent, “all in” prices for standardized services required to fully complete a clinical intervention.
- Require all providers to participate in this bundled pricing system.
- The prices posted for these services should be “walk up” prices available to all patients, irrespective of their insurance status.
- 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.
- 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.”
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.