The price of health care in the United States is already high and continues to rise at unsustainable rates, driving affordability challenges and representing a major policy priority.1 The high price of health care is not evenly distributed: prices charged for care vary between insurance types, across geographic areas, and even between providers within a region.2 This report is the third in a series that explores how states that are seeking to lower the cost of care can also advance health equity as part of that effort through policy design and implementation, rather than as an afterthought.3 This report focuses on reference pricing: payers setting upper payment limits for health care services to normalize and lower health spending.
Authors
Organizations mentioned
- Pages
- 16
- Published in
- United States of America
Table of Contents
- State Reference Pricing Can Lower Health Care Costs Equitably 1
- THOMAS WALDROP 1
- LEX BRIERLEY 1
- The Price of Health Care Varies Inequitably 2
- Reference Pricing Can Address Inequitable Variation 3
- California 3
- FIGURE 1 3
- FIGURE 2 3
- Montana 3
- Oregon 4
- How to Ensure Reference Pricing Is Done Equitably 5
- Collecting Accurate, Representative Data to Identify Price Variation 5
- FIGURE 3 6
- FIGURE 4 6
- Establishing Equitable Reference Rates 6
- Ensuring Provider Participation 7
- Minimizing Patient Cost-Shifting 7
- Reinvesting Savings to Promote Health Equity 8
- Reference Pricing Can Lower Health Care Costs and Promote Health Equity 9
- Notes 9
- Thomas Waldrop, Fellow 12
- Lex Brierley, Health Care Intern 12
- LATEST 12
- How States Can Advance Health Equity While Lowering Costs 12
- Tracking Progress of the Black Maternal Health Momnibus 13
- Enhanced ACA Marketplace Tax Credits Worked—And Shouldn’t Be Eliminated 14
- Health Policy for Older Americans Better Under President Biden than Trump 14
- How States Can Relieve the Burden of Women’s High-Cost Private Health Coverage 15
- Employer Child Care Strategies: 5 Things To Consider 15
- Stay informed by signing up for our mailing list 16