Session (CTI)

For several decades, health policy makers have argued for greater transparency of prices and quality. The US Department of Health and Human Services mandated hospitals to post list prices, or chargemasters, for services as of January 1, 2019. As a result of legislation that began in early 2021, hospitals are required to post payer-specific negotiated charges and discounted cash prices in machine-readable files and to disclose these charges for 300 “shoppable” services, 70 of which were specified by the Center for Medicare & Medicaid Services (CMS). While some may hypothesize that elevated prices correlate with enhanced quality and improved patient outcomes, empirical evidence suggests otherwise. For example, the higher price of a pancreatectomy at one NCI-Designated Cancer Center is justified if the complication and readmission rates are substantially lower. Instead, Sankaran et al. join others and suggest that factors, such as geographic location and market dynamics, play a more significant role in price determination, overshadowing any potential link between price and quality. These findings hold profound implications for various stakeholders within the healthcare ecosystem. Patients, often tasked with navigating the complexities of healthcare pricing, must recognize that higher costs do not necessarily translate to better outcomes. Similarly, payers, armed with insights from this study, are urged to reevaluate their negotiation strategies and prioritize value-based contracting to ensure optimal resource allocation. The need for future research underscores the evolving nature of healthcare pricing dynamics and the imperative to continually reassess policy interventions. As we strive to optimize the intersection of affordability and quality in healthcare delivery, rigorous investigation and evidence-based policymaking remain paramount.