What to Expect from Uniform Pricing of Health Care Services

Competing health insurance companies usually do not pay the same doctor the same price for the same procedure. Quite often a doctor will get paid one rate from Medica and another from HealthPartners; people who pay out of pocket are charged yet another rate. Large health plans can use their size to negotiate lower prices, which some people argue restricts competition and results in an unfair advantage. To level the playing field, some policymakers suggest that the state should prohibit doctors from charging varying prices and require uniform prices for all payers, with the exception of government health care programs and charity care.

Uniform pricing hopes to fix a number of problems, yet any positive effect may be limited because uniform pricing fails to address their root cause. Moreover, as will be explained here, uniform pricing can lead to unintended consequences, including higher average prices, reduced access, underutilized health care facilities, and more aggravating health plan policies.

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