As they face higher prices and increased cost sharing, consumers and employers are demanding more information about care services, options, and value. Responding to these demands may seem simple on the surface, but sharing meaningful information can create conflicts with providers, contractual obligations, and network strategy. The result has been criticism of payer-developed transparency tools that offer limited services lists and are lacking in outcomes data. Providers have also objected to these tools over questions of fairness.
While many fear transparency, those organizations that deliver superior value will win in such an environment. As regulations and insurance exchanges have forced plans to become more similar and have made side-by-side comparisons easier, the need for differentiation is greater than ever. Pressure to make more information on costs and quality available and to compete on that basis will raise the stakes for payers and providers alike. They’ll need to work very differently together to turn transparency into a business driver.
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