Greater Price Transparency Research Articles

Playing by the Rules? Tracking U.S. Hospitals' Responses to Federal Price Transparency Regulation.

As of January 1, 2021, the Centers for Medicare & Medicaid Services requires most U.S. hospitals to publish pricing information on their website to help consumers make decisions regarding services and to transform negotiations with health insurers. For this study, we evaluated changes in hospitals' compliance with the federal price transparency rule after the first year of enactment, during which the Centers for Medicare & Medicaid Services increased the penalty for noncompliance. Using a nationally representative random sample of 470 hospitals, we assessed compliance with both parts of the hospital transparency rule (publishing a machine-readable price database and a consumer shopping tool) in the first quarter of 2022 and compared its baseline level in the first quarter of 2021. Using data from the American Hospital Association and Clarivate, we next assessed how compliance varied by hospital factors (ownership, number of beds, system membership, teaching status, type of electronic health record system), market factors (hospital and insurer market concentration), and the estimated change in penalty for noncompliance. By early 2022, 46% of hospitals had posted both machine-readable and consumer-shoppable data, an increase of 24% from the prior year. Almost 9 in 10 hospitals had complied with the consumer-shoppable data requirement by early 2022. Larger hospitals and public hospitals had lower probabilities of baseline compliance with the machine-readable and consumer-shoppable requirements, respectively, although public hospitals were significantly more likely to become compliant with the consumer-shoppable requirement by 2022. Higher hospital market concentration was also associated with higher baseline compliance for both the machine-readable and consumer-shoppable requirements. Furthermore, our analyses found that hospitals with certain electronic health record systems were more likely to comply with the consumer-shoppable requirement in 2021 and became increasingly compliant with the machine-readable requirement in 2022. Finally, we found that hospitals with a larger estimated penalty were more likely to become compliant with the machine-readable requirement. Longitudinal analyses of compliance with the federal price transparency rule are valuable for monitoring changes in hospitals' behavior and assessing whether compliance changes vary systematically for specific types of hospitals and/or market structures. Our results suggest a trend toward increased hospital compliance between 2021 and 2022. Although hospitals perceive the consumer-shopping tools as being the most impactful, the value of this information depends on whether it is comprehensible and comparable across hospitals. The new price transparency rule has facilitated the creation of new data that have the potential to significantly alter the competitive landscape for hospitals and may require hospital leaders to consider how their organizational strategies change concerning their engagement with payers and patients. Finally, greater price transparency is likely to bolster national policy discussions related to price variation, affordability, and the role of regulation in healthcare markets.

A Decentralized Auction Model for Sustainable Housing Rental Market

The Internet of Things has driven the transformation of the traditional offline rental model to online rental platforms such as Zillow, Zigbang, and Lianjia. These platforms provide abundant housing options, detailed information, convenient communication, and greater price transparency. However, existing online rental platforms are still centralized and rely on third-party intermediaries for settlement, which raises concerns about the integrity of real estate data, transaction security, and price transparency. To improve the real estate leasing business, we propose leveraging the decentralized nature of blockchain technology. By eliminating intermediaries, we can ensure customer privacy and reduce transaction costs. This strategy revolves around smart contracts as a core component, automatically matching landlords and tenants based on their offers, achieving transparency, and maintaining anonymity for both parties. We introduce a novel auction system that combines the features of interactive auctions and sealed-bid auctions, enabling landlords and tenants to engage in range bidding. In this study, we developed a detailed algorithm to define how smart contracts function during the auction process. Through a cost analysis, we demonstrate the economic feasibility and provide a secure, transparent, and reliable approach for online auctions.

Willingness to Vaccinate (WTV) and Willingness to Pay (WTP) for Vaccination Against Peste des Petits Ruminants (PPR) in Mali.

PPR remains a major challenge to smallholder farmers in Mali. To understand the drivers of low adoption of vaccination by farmers, we analyzed the socio-economic factors influencing farmer WTV during and in the absence of vaccination campaigns. Given that the costs associated with vaccination are largely borne by farmers, we assessed factors that associated with farmer willingness to pay (WTP) more than the current price (150 XOF per dose) by considering two attributes of improvement of the vaccines empirically highlighted as potential leverage points for intervention: access of farmers to vaccines (reducing the distance to the vaccine) and availability of information about the quality of the vaccine (introducing a vaccine viability detector). Data were collected in Mopti and Sikasso regions from 304 producers. Overall (n = 304), 89 percent of respondents vaccinated their herds during official vaccination campaigns. They are associated with receiving information on the campaign calendar more quickly if information is relayed at places of worship and if they have an awareness of the benefits of vaccination, including the protection of third parties. Only 39 percent of respondents vaccinate outside vaccination campaigns. They are positively linked to the credibility of private veterinarians and a recognition of the vital importance of vaccines but are negatively associated with ignorance of vaccination needs and concern about vaccine side-effects. Both distance-effects and quality-tracker effects are associated with farmer willingness to pay more than the current vaccine prices. Farmers practicing semi-intensive production systems are willing to pay 20 percent more than the current vaccine prices, as are users who believe in the beneficial effects of vaccination, users who consider the prices of vaccines as fair, and those who believe that some vaccines are more important than others. Factors that discourage producers from vaccinating or from paying more for vaccination would be more effectively managed with better communication on vaccine benefits through targeted information dissemination campaigns by Malian authorities. Greater price transparency throughout the vaccine production and deployment chain is critical, while timely availability of vaccine tested for viability would increase the willingness to vaccinate while improving access.

Insulin price components: case studies in six low/middle-income countries

IntroductionUnderstanding price components for insulin products can help design interventions to improve insulin affordability in low/middle-income countries.MethodsAn adapted WHO/Health Action International standardised methodology was used in Brazil (Rio de Janeiro),...

Trends in Prices of Popular Brand-Name Prescription Drugs in the United States

High and continually increasing pharmaceutical drug spending is a major health and health policy concern in the United States. To demonstrate trends in prices among popular brand-name prescription drugs. This economic evaluation of drug prices focuses on 49 top-selling brand-name medications in the United States. Pharmacy claims data from January 1, 2012, through December 31, 2017, were obtained from Blue Cross Blue Shield Axis, a database that includes data from more than 35 million individuals with private pharmaceutical insurance. Drugs that exceeded $500 million in US sales or $1 billion in worldwide sales were examined. The median sum of out-of-pocket and insurance costs paid by patients or insurers for common prescriptions, presented annually and monthly, was the primary outcome. In total, 132 brand-name prescription drugs were identified in 2017 that met the inclusion criteria. Of this total, the study focused on 49 top-selling drugs that exceeded 100 000 pharmacy claims. Substantial cost increases among these drugs was near universal, with a 76% median cost increase from January 2012 through December 2017, and almost all drugs (48 [98%]) displaying regular annual or biannual price increases. Of the 36 drugs that have been available since 2012, 28 (78%) have seen an increase in insurer and out-of-pocket costs by more than 50%, and 16 (44%) have more than doubled in price. Insulins (ie, Novolog, Humalog, and Lantus) and tumor necrosis factor inhibitors (ie, Humira and Enbrel) demonstrated highly correlated price increases, coinciding with some of the largest growth in drug costs. Relative price changes did not differ between drugs that entered the market in the past 3 to 6 years and those that have been on the market longer (number of drugs, 13 vs 36; median, 29% increase from January 2015 through December 2017; P = .81) nor between drugs with or without a Food and Drug Administration-approved therapeutic equivalent (number of drugs, 17 vs 32; median, 79% vs 73%; P = .21). Changes in prices paid were highly correlated with third-party estimates of changes in drug net prices (ρ = 0.55; P = 3.8 × 10-5), suggesting that the current rebate system, which incentivizes high list prices and greater reliance on rebates, increases overall costs. The growth of drug spending in the United States associated with government-protected market exclusivity is likely to continue; greater price transparency is warranted.

Ensuring a Healthy and Competitive Market for Open Access Publishing

Watch the VIDEO.Alongside improving access to the outputs of scholarly research, helping to ensure a healthy and competitive market for scholarly publishing was one of the original objectives of the Open Access movement. Early OA advocates argued that a shift towards Open Access publishing models would level the playing field between small and large publishers, provide greater price transparency, and lower the overall costs of the scholarly publishing system. However, in recent years there has been a significant growth in centralized funding models for Open Access that are modelled on, and in some cases included within, the “Big Deal” subscription bundles that OA advocates had hoped to displace. This talk will discuss the current landscape of the Open Access publishing market and highlight important risks and opportunities for the health of this market in the coming years.

Price Fairness Perception in Online and Offline Environment – the Same or Different?

The author studies the role of perceived fair price as a reference price. The purpose of the publication is to answer two research questions connected with price fairness perception. In the first part of this article the theoretical background of the price fairness perception is presented. In the second part the results of author’s own research are shown. This quantitative research was realized in 2014 and concerned the durable goods. In the empirical part of paper, the author points out the importance of perceived fair price as a reference price. It is also stated that in the online environment the importance of perceptions of price fairness significantly increases due to greater price transparency in online sales channels.

Removing the Veil: Price Transparency in Interventional Radiology

In 2011, national health care expenditures totaled $2.7 trillion, doubling in the span of a decade and accounting for 18% of the United States gross domestic product (1). Experts recognize that current spending trends are unsustainable and that a multifaceted approach to health care reform is necessary. Price transparency provides one avenue through which cost containment may be achieved, as “price opacity” tends to be the norm in the current health care market (2–4). A recent study found that only 16% of randomly selected US hospitals were able to provide pricing information for total hip arthroplasty, a common elective surgical procedure (3). This lack of cost clarity complicates patient and clinician efforts to factor financial considerations into health care utilization decisions. Although legislation addressing price transparency was notably absent from the Patient Protection and Affordable Care Act of 2010, several other federal bills have been recently introduced to assist patients in obtaining pricing information (5). Additionally, more than half of all states have considered or pursued legislation to require price transparency in medicine (6). Price transparency efforts are likely to affect all health care providers, including interventional radiologists, so familiarity with this topic is of paramount relevance. This article will review the rationale behind price transparency, discuss its potential for curbing rising health care costs, and consider the impact of greater price transparency on interventional radiologists.

Shopping For Price In Medical Care

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.

Price discovery in the aluminum market

An extended version of the S. Beveridge and C. R. Nelson (1981) decomposition and a latent variable approach are used to examine how the noise content, and therefore the informativeness, of four aluminum prices that have been quoted at various times since 1970—the (now defunct) U.S. producer price, a transactions price reported in a trade journal, and the LME and Comex exchange prices. It was found that the start of aluminum futures trading in 1978 resulted in greater price transparency in the sense that the information content of transactions prices increased. LME prices quickly came to be more informative than published transactions prices. Although the initial Comex aluminum contract failed to attract liquidity and had low information content, the 1999 contract, trading currently, is as transparent as the LME contract. © 2005Wiley Periodicals, Inc. Jrl Fut Mark 25:967–988, 2005