Beyond Hospital Transparency: Getting the Facts Straight
July 11, 2024 • 12 PM - 1:15 PM (CT)

New data transparency reinforces what we have long known: hospital prices are out of control, and we can’t rely on health systems and health plans to course correct. In fact, data indicate that for most hospitals a “fair price” for patients who are privately insured by employers is 140%–200% of what Medicare pays for the exact same procedures and services at the exact same facilities — with some hospitals charging more than 500% of Medicare prices. A fair price should allow for a reasonable markup from verifiable costs, yet hospital associations continue to support industry opacity rather than collaborating with employers and other plan sponsors to move from revenue focused to value alignment.

Attend this roundtable where you will gain a better understanding of how myths around hospital prices perpetuate this problem and what to do about them.

One example:
MYTH #1: Hospital prices are based on the cost of providing care to patients and the ability to invest in improvements in quality and infrastructure.
FACT #1: There is no correlation between hospital prices and the actual cost of providing that care. It is not clear that what is being charged or investing in “improvements” has anything to do with providing care for patients, since there has been no demonstrated improvement in quality or care. Instead, it appears that vertical integration is being used to raise prices to what the market will bear without any cost accounting—and for-profit maximization. Hospitals are not transparent about investments, surplus, staffing, overhead costs, acquiring practices, or how they are spending the money or setting prices.

This is a must attend session for all employers – what you learn may shock you!

Upcoming Employer Member Roundtables:

• August 8 - TBD
• September 12th - Hospital Fair Pricing