Variation in price - and in quality - result from the fragmented, US approach to health care; we don’t see these kinds of issues in other developed countries. Price transparency will become more important as Accountable Care Organizations (ACOs) develop their risk contracting models. Further, I expect that tools to help consumers understand price variation in health care will play an increasing role in advancing payment reform.
Wednesday, February 6, 2013
Price Variation Is Not Just an Out-of-Network Issue
A recent New York Times article described high fee variation for some out-of-network providers, highlighting a cost issue that is definitely an unsolved problem and particularly costly for patients. But the problem is not limited to out-of-network providers. Another area of variation should also be examined; namely, price variation within networks. For example, in looking at specialty drug pricing within network, research at Truven Health has found as high as a ten-fold variation in pricing for some specialty oncology drugs.