The Need for Transparency in Health Care Markets: Clearing the Fog to Make the Market Work

David Balto, Law Offices of David Balto

Abstract

This paper will examine what all health care market participants stand to gain from increased transparency as well as the importance of standardization, data reporting to regulators, and disclosure to consumers in achieving the potential benefits of cost control, quality effects and access impact. With respect to the recent health care reform bill, I will outline the transparency provisions achieved under PPACA and will evaluate them in terms of the necessary preconditions of transparency. Using the hospital systems in Wisconsin and Colorado, detailed hospital reports published by New Hampshire and Maine, and the savings resulting from transparent contracts with pharmacy benefit managers, I will lay out examples of the potential success of transparency reform. Finally, I will address the anticompetitive concerns surrounding price sharing and present recommendations for effective implementation of transparency under PPACA as well as for any future efforts at transparency reform.