True Market Forces Will Soon Be Unleashed in Healthcare

In a matter of months, our healthcare system and the overall patient experience will change dramatically for the better. And most Americans don’t even realize it. 

After decades of attempts to transform the healthcare system into a true market—one in which forces like competition between providers based on quality and pricing can bring prices down, it is finally happening. The federal government’s new Transparency in Coverage Rule based on provisions of the Affordable Care Act means that 212 million consumers will be given ready access to the prices of virtually every test and procedure so they can decide for themselves whether to spend, say, $800 for an MRI of the lower back or $6,000.  And, believe me, the prices for an MRI of exactly the same quality can be that dramatically different, within a 10 miles radius—or less.

This massive and welcome sea change in health care is unfolding right now, and health providers, insurers and employers will be scrambling to keep up. Why?  Because initial compliance begins on January 1, 2022.  And as of January 1, 2023, employers can be fined $100 per insured individual per day for not arming them with access to comprehensive, transparent, easily accessible competitive pricing options. This should be a welcome mandate for companies, however, as it promises to dramatically reduce their health care expenditures, thus positively impacting their bottom line.

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