Towards Affordable Care: Policies To Reduce Price Variability | AHRQ Innovations Exchange

AHRQ’s Health Care Innovations Exchange Focuses on Policies To Reduce Price Variability

The latest issue of AHRQ’s Health Care Innovations Exchangeexplores hospital pricing for elective procedures, which can vary significantly across facilities within a given market area. Differences are typically unrelated to variations in quality of care. The featured profilein California, where state legislation promotes fair hospital pricing, describes a retirement system that incorporated a reference-pricing policy for certain procedures in its benefits design, enabling plan enrollees to select high-value hospitals. Featured quality tools include a tool for consumers to estimate how much providers charge for medical and dental services in their area, a website to help patients in California navigate the application process for discounted care from hospitals and a guide for consumers on the average cost of health care services to support price comparisons.

California Law Enhances Access to Affordable Care by Limiting Amount Hospitals Can Collect From Low-Income Uninsured and Underinsured Patients | AHRQ Innovations Exchange

Towards Affordable Care: Policies To Reduce Price Variability

Hospital pricing for elective procedures can vary significantly across facilities within a given market area, and differences are typically unrelated to variations in quality of care. Under most benefit plans, insured consumers lack incentive to choose hospitals offering a lower price for these services. In addition, prices charged for general hospital care often differ based on patients’ insurance status.

The featured policy Innovations describe a retirement system that incorporated a reference-pricing policy for certain procedures in its benefits design, enabling plan enrollees to select high-value hospitals; and California state legislation that promotes fair hospital pricing.

The featured QualityTools include a tool for consumers to estimate how much providers charge for medical and dental services in their area, a Web site to help patients in California navigate the application process for discounted care from hospitals, and a guide for consumers on the average cost of health care services to support price comparisons.

Featured Innovations:

• California Law Enhances Access to Affordable Care by Limiting Amount Hospitals Can Collect From Low-Income Uninsured and Underinsured Patients
with Story

• Reference-Pricing Policy for Hip/Knee Replacements Generates Significant Savings by Encouraging Enrollees To Choose High-Value Facilities

Featured QualityTools:

• FAIR Health Consumer Cost Lookup
Developed by FAIR Health

• HospitalBillHelp.org
Developed by Health Access California

• Transparency Health Care Prices in Virginia
Developed by Virginia Health Information

Also in This Issue:

Innovations >

• Mental Health Center Provides Integrated Primary Care and Care Coordination to Medicaid Beneficiaries With Severe Mental Illness, Enhancing Access to Services and Improving Outcomes

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