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Revealing the Secret Prices Insurers Pay Can Save Health Care

Sep 2019

The government continues to step in to try and help the American people with the rising costs of healthcare. An HHS proposal would shed light on the secret negotiated prices insurance companies pay. Making these prices public would infuse much-needed competition into health care’s bloated secret pricing and potentially drive down costs for patients while increasing competition for patients. As the employers wait for any government help to make the needed changes, Medxoom’s modern marketplace technology can help provide price transparency on current wide cost variations for the same medical services among providers.

From STAT:

“Why hasn’t this happened already? Insurers and hospitals keep the prices they negotiate confidential. Insurers then sell these secret pricing deals to employers, who are also contractually bound to keep them secret. In the process, hospitals have become seasoned veterans in playing the sometimes absurd price markup-discount game that creates mirages of generous discounts.

This game gives hospitals a profit margin they can control. It also allows some hospitals to appear charitable when they offer a 20% discount to an out-of-network patient even though the bill may be marked up by 500%. For insurers, higher hospital prices are managed through the actuarial science of passing them on as higher premiums the next year.“

If real prices were disclosed, we would see the same fierce competition that now dominates the airline industry change the business of medicine. The absence of real prices also fuels the problem of price gouging and predatory billing. One in five Americans has had medical debt pursued by a collection agency, and medical bills hurting individuals’ credit scores has become a commonplace occurrence.”

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