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提高医疗保健成本透明度:评估实施挑战、批评意见及替代解决方案。

Enhancing healthcare cost transparency: assessing implementation challenges, criticisms, and alternative solutions.

作者信息

Malik Sonia Ali

机构信息

Department of Pulmonary/Sleep Medicine, University of Utah, Salt Lake City, UT, United States.

出版信息

Front Health Serv. 2025 Jan 13;4:1379416. doi: 10.3389/frhs.2024.1379416. eCollection 2024.

Abstract

The United States healthcare system grapples with a staggering estimated waste of $935 billion, with pricing failure contributing a substantial $240.5 billion. This paper explores an innovative solution to combat rapidly escalating healthcare costs by proposing measures that would complement the mandated disclosure of healthcare prices. The Centers for Medicare and Medicaid Services (CMS) introduced a significant rule for hospital pricing, effective January 1, 2021, aiming to enhance transparency and empower patients to make value-based decisions. However, this rule has faced criticisms on various policy grounds which this examination delves into. To address these concerns and enhance the effectiveness of price transparency, this paper suggests complementary and/or alternative strategies and solutions while also examining the engagement of enrollees in price transparency tools.

摘要

美国医疗保健系统面临着估计高达9350亿美元的惊人浪费,其中定价失误造成了高达2405亿美元的巨大损失。本文探讨了一种创新解决方案,通过提出补充医疗保健价格强制披露的措施,来应对迅速攀升的医疗成本。医疗保险和医疗补助服务中心(CMS)于2021年1月1日出台了一项重要的医院定价规则,旨在提高透明度,使患者能够做出基于价值的决策。然而,这项规则在各种政策层面受到了批评,本文将深入探讨这些批评。为了解决这些问题并提高价格透明度的有效性,本文提出了补充性和/或替代性策略及解决方案,同时还研究了参保人对价格透明度工具的参与情况。

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