Peterson Center on Healthcare

ICYMI: In response to a new Presidential Executive Order directing the Secretaries of Treasury, Labor, and Health and Human Services to rapidly issue updated regulatory guidance to strengthen price transparency, David Muhlestein details recommendations to unlock the full potential of healthcare price data. Recommendations include: ?? Improving how price data is shared ?? Enhancing price data with information about volume, plan design, and pharmaceutical prices ?? Expanding the types of providers and payers that are required to report their price Data has the power to improve healthcare market competition by equipping purchasers with information about prices, spending, utilization, and outcomes. Learn more about how the Center is working to advance data transparency: https://lnkd.in/e6er6KxR #DataTransparency #AffordableHealthcare

Mairin Brady Mancino recently shared with Deanna Cuadra why better pricing data can inform employer benefit design decisions and lower healthcare costs while improving care. Read more of their conversation in Employee Benefit News: https://lnkd.in/emPRXq9X #AffordableHealthcare #DataTransparency

The rates negotiated between payers and providers is critical #healthcare price data. But under many contracts, actual paid amounts can vary based on?contractual allowances, volume discounts, reimbursement ceilings, co-insurance, or other factors. ?In his new Health Affairs?article, David Muhlestein recommends that in addition to the negotiated rate, price data should also include average paid amounts.? https://lnkd.in/eXPrRWp3? #pricetransparency?

Through our partners and grantee, the Peterson Center on Healthcare has learned how difficult #healthcare price data is for employers to access, analyze, and use. With a recent Executive Order proposing to update and strengthen price transparency regulation, Caroline Pearson discusses to enforce compliance and how to standardize and enhance the data that payers and providers must report: https://bit.ly/4kV5LwF

The recent executive order on price transparency is an opportunity to advance more functional and affordable healthcare markets for consumers and employers. Recommendations from the Peterson Center on Healthcare include: 1. Standardize how hospital and payer data are shared to improve usability. 2. Collect better data that provide a more accurate picture of costs and spending. 3. Require all health plans, not only commercial plans, to report price data. 4.?Increase enforcement activities and penalties that will improve compliance. 5.?Strengthen employers’ access to claims data to unlock healthcare cost reduction opportunities. 6.?Improve public access to price data so consumers can consider price and quality information before receiving care.?? Read more about these recommendations in the article below. To learn about our work on price transparency, visit https://lnkd.in/gnkMsJa7

The fight to enforce hospital price transparency continues. Mairin Brady Mancino, senior advisor of policy at Peterson Center on Healthcare, shares why employers should be invested in the outcome. Read more on Employee Benefit News. https://lnkd.in/eGRCVrCq

Price transparency data can be used to answer countless questions that have long existed in healthcare. I've been able to use it effectively for academic papers, policy analysis and helping clients answer their strategic questions. However, it is incredibly difficult to use with a very high barrier to entry, making it so that very few people are able to successfully leverage it. Today, my article in Health Affairs Forefront discusses how to lower the barriers to entry. President Trump recently released an executive order doubling down on price transparency and directing multiple agencies to release revised regulations to further the release of this data within 90 days. (see https://lnkd.in/erJ_GVPy) To help these agencies , I've identified 14 recommendations in 4 categories that will help improve the quality of the data and make it so more people can use it, helping it achieve its potential. Improve How Data Is Shared 1. Deliver data in a relational structure – create a standardized schema to share the data that is accessible to most researchers, analysts and programmers 2. Report data location – require all organizations to report to CMS the location of where data is stored on their website Enhance the Current data 3. Include drug data 4. Include volume data 5. Report negotiated rates and average payment amounts 6. Link to standardized plan information/benefit design 7. Include group names and addresses 8. Add quality data 9. Give the HHS Secretary discretion to require additional information Expand Who Reports Transparency Data 10. Require all health plans to report data – include Medicare Advantage, Managed Medicaid, Tri-Care and all other plans 11. Expand providers that must report data – expand beyond hospitals to include physician offices, laboratories, pharmacies, urgent care, post-acute care providers, etc. Enhance Compliance 12. Allow members of the public to report non-compliance 13. Require organizations to include contact information to get answers to questions about the data 14. Require certification of compliance with requirements Additionally, it would be good to enhance the current regulations by passing legislation that codifies price transparency requirements. If you have thoughts about improving the data or would like to chat, please reach out. I'm grateful to the Peterson Center on Healthcare who supported this work. Read the full article at: https://lnkd.in/e2pTDnsR #pricetransparency #healthcareprices Simple Healthcare

??Price transparency is foundational to competitive healthcare markets and affordable, accessible, high-quality care. In a new Health Affairs article, David Muhlestein highlights the challenges of analyzing payer price data and provides recommendations to unlock this data’s full potential. This research comes on the heels of a Presidential executive order directing the Secretaries of Treasury, Labor, and Health and Human Services to rapidly issue updated regulatory guidance to strengthen price transparency. Dive into the new research: #AffordableHealthcare #DataTransparency

At the Peterson Center on Healthcare, we are partnering with states to identify solutions that improve the affordability, efficiency, and the performance of their health systems. We are particularly interested in strengthening the use of data to inform policy and market decision-making to ensure high value, affordable healthcare. This is why we are thrilled to see a new report released by the One Utah Health Collaborative after months of research and analyses which provides the most comprehensive all-payer view into #Utah's healthcare landscape. When states have a comprehensive and cohesive picture of cost growth patterns across insurance markets using a standard set of metrics, it equips them with the data needed to make more informed assessments about the problem and better solutions that reflect the whole system and the whole community. The Collaborative is a bright spot when we think about advancing healthcare initiatives across the country: they are starting early, they are starting with data, and they are starting with their stakeholders. Congratulations to the Collaborative for providing unprecedented transparency into spending trends that impact affordability and access. This marks a major milestone in Utah’s affordability journey – one that is guided by data, collaboration, and shared accountability. We are proud to be partners on this journey toward statewide healthcare transformation and look forward to future milestones!?? James Wissler John Poelman Sri Bose, Ph.D., MA Elise Saarela #AffordableHealthcare #DataTransparency

Rising healthcare costs are straining states’ budgets. Some policymakers are considering passing costs on to public employees via premiums, Maya Goldman from Axios reports. Affordability is a challenge for everyone in the United States, from public and private employers to workers and consumers. Federal- and state-level solutions that make care more efficient are urgently needed to reshape the health system into one that works for everyone. Read more: #HealthcareCosts #HealthSpending #PublicService