How to Create a Better Consumer Market for U.S. Health Care

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Four steps to put consumers in the driver’s seat.

. Soon-to-be implemented cost-sharing estimates, available through online tools and based on health insurance coverage, are also promising and will further shift market power away from the facilities and institutions that have benefited from legal price secrecy.

To put consumers in the driver’s seat, CMS, working with Congress, can address both through four refinements to the current rules.Medical care providers should be forced to specify their prices for a list of standardized, consumer-focused bundles of services tied to full episodes of clinical interventions. These bundles of services should act as the minimum — as determined by physician consensus — needed to deliver a given intervention.

Transparent, “all in” prices for a standardized list of services required to fully complete a clinical intervention would address this problem and empower patients. With standardization, they could see clearly the full price of the clinical bundles and make apples-to-apples comparisons. The prices charged by competing networks of providers would be directly comparable because the clinical services included in what is being priced would be the same.

 

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