Despite hurdles, healthcare transparency is still a noble goal – and one within our grasp


It’s no surprise that Americans continue to push for transparency about their healthcare costs, especially as many struggle to find affordable and accessible treatment options.

And why shouldn’t they? In this country, our largest systems work best when the default expectation is transparency — from our criminal justice system to our publicly traded companies to our elections, it is critical for their functionality that the general public be privy to as much information as is reasonably possible be entitled.

There are common sense caveats: who you vote for is private, and corporations shouldn’t give up their proprietary “secret sauce,” but the expectation is that the public should have insight into the institutions that shape their lives.

So, as we look at healthcare, it’s time to acknowledge that the drive for regulatory transparency is hitting a wall, and explore what else we have in our toolbox to achieve that noble goal.

It’s time for leaders to embrace technology-enabled, collaborative approaches

Healthcare spending topped $4.3 trillion in 2021 and is projected to increase to $6.8 trillion by 2030, according to projections from the Centers for Medicare and Medicaid Services.

As prices continue to rise, policymakers and healthcare industry leaders must pave the way for new, transformative technologies to achieve greater transparency and collaboration across the healthcare system. So far, current laws on the drug price transparency books limit who must share data and how, creating gaps where prices are visible to consumers.

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An analysis by the University of Southern California’s Leonard D. Schaeffer Center for Health Policy and Economics examined 166 recently enacted drug pricing laws and found that most laws with a transparency component were tightly worded and did not require all stakeholders to share pricing data.

Researchers concluded that these laws have limited impact and do not provide full transparency across the distribution system, despite the “huge resources expended on their implementation.”

Hospitals recently confronted with new CMS transparency rules are operating in a “flawed system,” according to a MedCity News article. A study shows that less than six percent of hospitals were able to fully comply with the new price transparency rules. Many hospitals simply lack the technological infrastructure to meet the demands.

To close these gaps, healthcare organizations can turn to innovative technologies that can make complex datasets more manageable and build trust on a common digital foundation.

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A blueprint for increasing transparency is already coming into focus in the 340B drug pricing program, where some stakeholders are seeing the value and gaining clarity of working from a common data set and collaborating more openly.

Working together to increase visibility

The use of technology can simplify the process and encourage collaboration between all parties, from drug manufacturers to hospitals.

Legislators should consider legislation that provides greater transparency across healthcare sectors while allowing for technological innovations that can simplify data sharing for stakeholders. Equal and diverse platforms create an environment where all parties are equal and can seamlessly share data to ensure laws are enforced effectively and work as intended.

While all transparency laws should incentivize a wider sharing of price data, we should definitely allow common sense caveats. Protected Health Information (PHI) must continue to be aggressively guarded by all stakeholders and technology partners.

Any new legislation should also protect those involved from retaliation once all information is disclosed. For example, safety-net healthcare providers using the 340B drug pricing program should not face reimbursement discrimination from payers.

Holistic solutions for the transparency of healthcare costs and drug prices should provide the access to key information Americans expect for the institutions they depend on. Fostering technological solutions that can connect individuals to key data must be a fundamental part of this approach. By making space for new technologies, we open the door to systemic change for the better.

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Always one step ahead

As our technology and healthcare needs continue to evolve, it is imperative that any transparency solutions we enact today are flexible enough to meet the challenges of tomorrow. Many facets of the healthcare system are siled, not considering how information can easily be shared across multiple platforms and sectors.

By simplifying the process and facilitating collaboration, we can improve end-to-end visibility across the healthcare system and identify solutions that can help meaningfully address rising healthcare costs.

We can provide the appropriate transparency that Americans deserve.

For legislators, this means passing laws that can create equitable and systemic visibility. For those in health tech, this means creating technology ecosystems that work with shared data to bring all stakeholders to the table.

Photo: Oleksandr Hruts, Getty Images



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