Ginsburg Paul B
Center for Studying Health System Change, Washington, DC, USA.
Health Aff (Millwood). 2007 Mar-Apr;26(2):w208-16. doi: 10.1377/hlthaff.26.2.w208. Epub 2007 Feb 6.
Insurers are well positioned to support their enrollees in shopping for care because of their ability to analyze complex data--reflecting both their negotiated discounts and the enrollee's benefit structure--should they decide to commit resources to this task. Government transparency initiatives can help those who are uninsured or want to use out-of-network providers with data on prices and all patients by gathering and disseminating data on quality. But clumsy requirements to disclose insurer-provider contracts could lead to higher prices. Greater price transparency might help curb rising costs, but many overstate the likely magnitude of its contribution.
保险公司有能力分析复杂数据(这些数据反映了他们协商的折扣以及参保人的福利结构),因此如果他们决定投入资源来完成这项任务,那么在帮助参保人挑选医疗服务方面具有很好的条件。政府的透明度倡议可以通过收集和传播质量数据,帮助那些未参保者或希望使用网络外医疗服务提供者的人了解价格数据以及所有患者的情况。但是,披露保险公司与医疗服务提供者合同的繁琐要求可能会导致价格上涨。更高的价格透明度可能有助于遏制成本上升,但许多人高估了其可能产生的贡献程度。