Unraveling the complexity of our health care billing system

Pricing transparency for health care services has long been considered a cornerstone of meaningful reform that could drive down prices.

How do employers know if they’re getting good value for their health care spend? How do they encourage their employees to be responsible health care consumers? Benefits advisors help position their clients with cost-effective health plans, but even within well-constructed networks, prices for services and procedures can vary wildly depending on where the employee is treated and by whom.

It’s not unusual, for example, to find one claim for $250 and another for $800 for an identical MRI of two different employees, the only difference being where the MRI was performed. Even worse, the employer and employee never know about the disparity in price until they get the bill. Similar examples are easy to find every day across the industry. In spite of the best efforts of benefits advisors and employers, finding the best possible value for health care services remains elusive due to a lack of transparency in pricing. It’s impossible to control price variations without the ability to look at the price tags.