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Price transparency

Philip Rocco, Andrew S Kelly, Daniel Béland, Michael Kinane
Prices are a significant driver of health care cost in the United States. Existing research on the politics of health system reform has emphasized the limited nature of policy entrepreneurs' efforts at solving the problem of rising prices through direct regulation at the state level. Yet this literature fails to account for how change agents in the states gradually reconfigured the politics of prices, forging new, transparency-based policy instruments called all-payer claims databases (APCDs), which are designed to empower consumers, purchasers, and states to make informed market and policy choices...
October 11, 2016: Journal of Health Politics, Policy and Law
Jennifer Prah Ruger, Marian Reiff
BACKGROUND: Microcosting is a cost estimation method that requires the collection of detailed data on resources utilized, and the unit costs of those resources in order to identify actual resource use and economic costs. Microcosting findings reflect the true costs to health care systems and to society, and are able to provide transparent and consistent estimates. Many economic evaluations in health and medicine use charges, prices, or payments as a proxy for cost. However, using charges, prices, or payments rather than the true costs of resources can result in inaccurate estimates...
October 5, 2016: JMIR Research Protocols
D Radic, S Haugk, M Radic
Ever since the introduction of the Market Restructuring Act, the evaluation and price negotiations of drugs have been controversial. While the Federal Joint Committee considers that the process is transparent and in accordance with clear evidence-based criteria, representatives of pharmaceutical companies are particularly critical of the fact that the central association of statutory health insurance is involved in both the determination of added therapeutic benefit of drugs as well as in the subsequent price negotiation...
September 16, 2016: Das Gesundheitswesen
Kyriakos Souliotis, Manto Papageorgiou, Anastasia Politi, Athanasios Athanasiadis
BACKGROUND: Affordable, accessible, and innovation-promoting pharmaceutical care is essential to the operation of a sustainable health system. External reference pricing (ERP), a common pharmaceutical policy in Europe, suffers today from indigenous weaknesses that may cause market distortions and barriers to care, burdening mostly the weak economies, and hence, raising ethical and political worrying. OBJECTIVES AND METHODS: A non-randomized experiment was conducted, in order to examine the influence of flexible and adaptable to health systems' affordability ERP structures...
2016: Frontiers in Public Health
Ge Bai, Gerard F Anderson
Many hospital executives and economists have suggested that since Medicare adopted a hospital prospective payment system in 1985, prices on the hospital chargemaster (an exhaustive list of the prices for all hospital procedures and supplies) have become irrelevant. However, using 2013 nationally representative hospital data from Medicare, we found that a one-unit increase in the charge-to-cost ratio (chargemaster price divided by Medicare-allowable cost) was associated with $64 higher patient care revenue per adjusted discharge...
September 1, 2016: Health Affairs
Katherine H Schiavoni, Lisa Soleymani Lehmann, Wendy Guan, Meredith Rosenthal, Thomas D Sequist, Alyna T Chien
BACKGROUND: Little is known about how primary care physicians (PCPs) in routine outpatient practice use paid price information (i.e., the amount that insurers finally pay providers) in daily clinical practice. OBJECTIVE: To describe the experiences of PCPs who have had paid price information on tests and procedures for at least 1 year. DESIGN: Cross-sectional study using semi-structured interviews and the constant comparative method of qualitative analysis...
August 25, 2016: Journal of General Internal Medicine
Joel Lexchin, Deborah Gleeson
The Trans Pacific Partnership Agreement (TPP) is a large regional trade agreement involving 12 countries. It was signed in principle in February 2016 but has not yet been ratified in any of the participating countries. The TPP provisions place a range of constraints on how governments regulate the pharmaceutical sector and set prices for medicines. This article presents a prospective policy analysis of the possible effects of the TPP on these two points in Canada and Australia. Five chapters of relevance to pharmaceutical policy are analyzed: chapters on Technical Barriers to Trade (Chapter 8), Intellectual Property (Chapter 18), Investment (Chapter 9), Dispute Resolution (Chapter 28), and an annex of the chapter on Transparency and Anti-Corruption (Chapter 26, Annex 26-A)...
October 2016: International Journal of Health Services: Planning, Administration, Evaluation
Charles C Lee, Kristopher T Kimmell, Amy Lalonde, Peter Salzman, Matthew C Miller, Laura M Calvi, Ekaterina Manuylova, Ismat Shafiq, G Edward Vates
PURPOSE: Geography is known to affect cost of care in surgical procedures. Understanding the relationship between geography and hospital costs is pertinent in the effort to reduce healthcare costs. We studied the geographic variation in cost for transsphenoidal pituitary surgery in hospitals across New York State. METHODS: Using the Healthcare Cost and Utilization Project State Inpatient Database for New York from 2008 to 2011, we analyzed records of patients who underwent elective transsphenoidal pituitary tumor surgery and were discharged to home or self-care...
October 2016: Pituitary
Kelly Cristina Inoue, Laura Misue Matsuda
OBJECTIVE: to identify costs of dressings to prevent sacral pressure ulcers in an adult intensive care unit in Paraná, Brazil. METHODS: secondary analysis study with 25 patients admitted between October 2013 and March 2014, using transparent polyurethane film (n=15) or hydrocolloid dressing (n=10) on the sacral region. The cost of each intervention was based on the unit amount used in each type of dressing, and its purchase price (transparent film = R$15.80, hydrocolloid dressing = R$68...
July 2016: Revista Brasileira de Enfermagem
Carlos Campillo-Artero, Sandra Garcia-Armesto, Enrique Bernal-Delgado
Given that drug innovation has been largely away from breakthroughs, arguing that a new drug recently approved and reaching the market is downright effective, safe and affordable is actually parlous. The soaring costs of an increasing number of new drugs (specially for cancer and rare diseases) threaten to supersede societal absorbing capacity, competing with other health and outside health sector resources. Some health systems are not making headways towards solving the current conundrum of keeping path with the state of the art regulatory mechanisms in delivering cost-effective, equitable and affordable treatments...
September 2016: Health Policy
E Paul Amundson
No abstract text is available yet for this article.
June 2016: South Dakota Medicine: the Journal of the South Dakota State Medical Association
Devdutta G Sangvai
Health care in the United States, and by extension in North Carolina, is in a perpetual state of flux. From the Nixon-era predictions of runaway costs to the insurance-anchored efforts of Hillarycare to wide-sweeping reforms of Obamacare, established providers are regularly counseling the next generation on how different medicine will look when they are in practice. The accuracy of some of these predictions aside, one thing is sure: the pace and magnitude of change is palpably different this time. Pushed by both private and public payers to move from fee-for-service to value-based care while striving to meet the Triple Aim of improving patient experience, improving population health, and reducing costs, all arenas of medicine--hospital-based, ambulatory, and public health--are feeling the pressure...
July 2016: North Carolina Medical Journal
Natasha Azzopardi-Muscat, Peter Schroder-Beck, Helmut Brand
The Joint Procurement Agreement (JPA) is an innovative instrument for multi-country procurement of medical countermeasures against cross-border health threats. This paper aims to assess its potential performance. A literature review was conducted to identify key features of successful joint procurement programmes. Documentary analysis and a key informants' interview were carried out to analyse the European Union (EU) JPA. Ownership, equity, transparency, stable central financing, standardisation, flexibility and gradual development were identified as important prerequisites for successful establishment of multi-country joint procurement programmes in the literature while security of supply, favourable prices, reduction of operational costs and administrative burden and creation of professional expert networks were identified as desirable outcomes...
July 12, 2016: Health Economics, Policy, and Law
Hannah Hamavid, Maxwell Birger, Anne G Bulchis, Liya Lomsadze, Jonathan Joseph, Ranju Baral, Anthony L Bui, Cody Horst, Elizabeth Johnson, Joseph L Dieleman
BACKGROUND: In 2013 the United States spent $2.9 trillion on health care, more than in any previous year. Much of the debate around slowing health care spending growth focuses on the complicated pricing system for services. Our investigation contributes to knowledge of health care spending by assessing the relationship between charges and payments in the inpatient hospital setting. In the US, charges and payments differ because of a complex set of incentives that connect health care providers and funders...
2016: PloS One
Genevieve M Halpenny
Turing Pharmaceuticals raised the price of Daraprim 5,500%, illustrating how the absence of competition in the sale of low-volume, low-price drugs can lead to price gouging. For patented medicines, society allows supracompetitive pricing to incentivize innovation. However, Gilead's decision to sell Sovaldi for $84,000 per course of treatment raised the question whether society must accept any price set by the patent holder. Unfortunately, these incidents illustrate a broader trend in which pharmaceutical prices are greater in the United States than abroad, placing the United States at the top in per capita expenditures on pharmaceuticals...
June 9, 2016: ACS Medicinal Chemistry Letters
Ameet Sarpatwari, Jerry Avorn, Aaron S Kesselheim
Spending on prescription drugs has risen sharply in the United States over the past 2 years. Although thousandfold price increases for a few generic products in limited use have attracted much attention, overall spending growth has been driven more by the widespread use of costly new agents such as..
June 16, 2016: New England Journal of Medicine
Byeong Jo Kim, Dong Hoe Kim, Seung Lee Kwon, So Yeon Park, Zhen Li, Kai Zhu, Hyun Suk Jung
Most research on perovskite solar cells has focused on improving power-conversion efficiency and stability. However, if one could refurbish perovskite solar cells, their stability might not be a critical issue. From the perspective of cost effectiveness, if failed, perovskite solar cells could be collected and recycled; reuse of their gold electrodes and transparent conducting glasses could reduce the price per watt of perovskite photovoltaic modules. Herein, we present a simple and effective method for removing the perovskite layer and reusing the mesoporous TiO2-coated transparent conducting glass substrate via selective dissolution...
2016: Nature Communications
Stephanie Pincetl, Erik Porse, Deborah Cheng
In the Los Angeles metropolitan region, nearly 100 public and private entities are formally involved in the management and distribution of potable water-a legacy rooted in fragmented urban growth in the area and late 19th century convictions about local control of services. Yet, while policy debates focus on new forms of infrastructure, restructured pricing mechanisms, and other technical fixes, the complex institutional architecture of the present system has received little attention. In this paper, we trace the development of this system, describe its interconnections and disjunctures, and demonstrate the invisibility of water infrastructure in LA in multiple ways-through mapping, statistical analysis, and historical texts...
August 2016: Environmental Management
Corinna C Zygourakis, Seungwon Yoon, Victoria Valencia, Christy Boscardin, Christopher Moriates, Ralph Gonzales, Michael T Lawton
OBJECTIVE Disposable supplies constitute a large portion of operating room (OR) costs and are often left over at the end of a surgical case. Despite financial and environmental implications of such waste, there has been little evaluation of OR supply utilization. The goal of this study was to quantify the utilization of disposable supplies and the costs associated with opened but unused items (i.e., "waste") in neurosurgical procedures. METHODS Every disposable supply that was unused at the end of surgery was quantified through direct observation of 58 neurosurgical cases at the University of California, San Francisco, in August 2015...
May 6, 2016: Journal of Neurosurgery
Keith Roberts
In response to 2 articles recently published in The American Journal of Managed Care, "Characterizing Health Plan Price Estimator Tools: Findings from a National Survey" (February 2016), and "National Estimates of Price Variation by Site of Care" (March 2016), by Higgins et al, this editorial details best practices that healthcare organizations should employ in an effort to improve pricing transparency, enhancing patient engagement, and ultimately change patient behaviors to improve patient outcomes. Specifically, this article details a fourfold framework to help healthcare organizations, including both payers and providers, to understand consumers across the spectrum of care...
2016: American Journal of Managed Care
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