Although the increasing consolidation of U.S. hospitals, physicians, and insurers may lead to improvements in efficiency and quality of care, the phenomenon also raises the potential for higher prices for health services. In the new issue of Health Affairs, two Commonwealth Fund–supported studies show that options available for counteracting providers' pricing power go well beyond antitrust enforcement.
- In Seeking Lower Prices Where Providers Are Consolidated: An Examination of Market and Policy Strategies, Paul B. Ginsburg and L. Gregory Pawlson discuss a wide range of strategies at the disposal of payers and policymakers to curb the market power wielded by providers. For example, they point to the information systems that many insurers are developing to produce real-time estimates of patients' out-of-pocket costs—data that patients could use to become more price-conscious when choosing providers.
- In Getting the Product Right: How Competition Policy Can Improve Health Care Markets, William M. Sage says that competition will improve only when providers "assemble and warranty" most of their products and stop billing for care processes, such as office-based procedures, and inputs, such as intravenous fluids, that are of uncertain value.
In their commentaries on www.healthaffairs.org, Bruce C. Vladeck and Martin Gaynor offer alternative perspectives on the Ginsburg/Pawlson and Sage proposals.