Price Transparency Is Anything But Transparent

Price Transparency Is Anything But Transparent

This IDC Perspective discusses price transparency in the healthcare industry."Price transparency, like allowing for insurance over state lines, is a politician's talking point. Nothing more. Exactly how many people will shop for rates, and exactly how many will get better deals, and be able to execute them? Very few," states Jeff Rivkin, research director, IDC Health Insights. "The vast majority of consumers are employer-insured and/or do not have the time, money, patience, medical literacy, or desire to actually shop for procedures. Even if they do, are they going to wait until open enrollment for their procedure, change insurance plans, and then schedule their procedure? Doubtful. Medicare and Medicaid are the only areas where standardization is possible and, even then, consumer inertia makes price transparency overblown."

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Executive Snapshot
Situation Overview
Regulation and Legislation Context
Lobbying Groups Have Responded
Analysis
Noun Recognition — What's a Big Mac?
Noun Recognition — What's a Pickle?
Location, Location, Location
Reimbursement Arrangement
Payer/Provider Contract Terms Latency
Process
Employers and Their Affiliations
Appointment Variables
Quality
Contracted Service Providers
Insurance Portability
Insurance and Un-Insurance
Advice for the Technology Buyer
Be Wary of Price Transparency Claims by Vendors
Payers Should Be Similarly Wary of the Seriousness of Price Transparency Mandates by Politicians and Legislators
Foresee Mandates Around Price Transparency Architecturally
Be Wary of "Real-Time Claims Adjudication" Road Maps
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Related Research
Synopsis

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