Transparency – Not as Clear as it Seems

 

Supreme Court Says “No” to Transparency in Healthcare. Hot off the presses, the Supreme Court ruled today AGAINST transparency in health care claims. Even though our government is all about transparency, there is still a long way to go to accomplish this goal. Anyone who has ever seen a medical bill is well aware that the health care costs in the United States are astronomical. For that reason 18 states in the U.S. have developed an “all-payer claims database” where all medical entities and health insurers report health care costs to the state.  This is a great stride for transparency. Medicare, the federal health insurance program, releases claims data for analytical purposes. While this offers transparency of health care costs within the Medicare population, Medicare recipients are not representative of health care recipients throughout the country. A large portion of Americans in the workforce are not on Medicare, but rather on self-funded plans with their employer. Thankfully agencies like ProPublica (an independent investigative source for the public interest) are examining the trends in health care utilization and spending to identify more efficiencies in health care costs.

To date, self-insured employers have not had to provide their medical data claim information to be analyzed and today the Supreme Court ruled that they don’t have to.

So how can we as a nation ever expect to bring down health care costs when we can only analyze a small piece of the puzzle? This article shows that doctors billing Medicare “billed ..for the most expensive type of office visits at least 90 percent of the time, compared to just 4 percent of office visits for all doctors”. With this type of outrageous overspending of taxpayer dollars, one would think that the Supreme Court would be in favor or transparency and against extorting the Medicare Program. We will have to push for increased transparency of all health care costs, both public and private insurance.

http://www.npr.org/sections/health-shots/2016/03/02/468756393/supreme-court-strikes-at-states-efforts-on-health-care-transparency

 

 - Tia