PRICE TRANSPARENCY IS VITAL:
Acute Care is the Exception, Not the Rule
The knee-jerk reaction to price transparency often boils down to: “You can’t shop in an emergency.” And while it’s true that nobody with a broken arm or heart attack stops to compare prices on the way to the ER, this line of reasoning ignores the bigger picture.
Emergencies are an edge case, not the norm. Here’s why price transparency is critical for most healthcare interactions.
1. Acute Care is the Exception
Of 18 billion healthcare treatments delivered annually, only 11.4 million ICU-level emergencies occur—just 0.063%. While acute care is essential and often unavoidable, it represents a tiny fraction of the healthcare landscape.
By contrast, the majority of healthcare interactions are predictable, planned, or routine, such as:
• 1.2 billion physician consults
• 400 million physical therapy visits
• 300 million radiology services
• 200 million gastroenterology procedures
Most treatments are non-acute and shoppable if pricing is transparent. Emergencies must not be used as an excuse to keep the rest of the system opaque.
2. People Already Shop—Without Prices or Choices
Even in today’s opaque healthcare system, people try to shop. The problem is they lack the information needed to make informed decisions. Prices aren’t available upfront, leaving patients blind until the bill arrives weeks later.
This is incredibly frustrating for the 90% of Americans who don’t reach their deductibles. Since most healthcare expenses are paid out-of-pocket, transparent pricing is not just helpful but essential.
3. The Market for Cash-Priced Services is Ripe
The potential for transparent cash pricing is enormous for services priced under $6,000. Imagine knowing an MRI costs $400 at one facility and $4,800 at another. For routine services like physical therapy, radiology, or planned procedures, transparency would empower patients to choose higher-value care and save money.
Employers, particularly those offering self-funded health plans, also benefit from price transparency. Even for acute scenarios, contracted rates help them better predict expenses, manage budgets, and control premium increases.
A Call to Action
Price transparency is about empowering patients for the 99.9% of treatments that are not acute emergencies.
It enables individuals to make better financial decisions, allows employers to negotiate fairer contracts, and forces health systems to compete, ultimately driving down expenses.
Let’s stop letting edge cases dictate the rules for the rest of the system. The future of healthcare is transparent, competitive, and patient-centered.
-Rojas out
I would even suggest that transparent prices for emergency services are valuable to a health system even if the proportion of these services is small.
Our society has grown increasingly distrustful of our institutions (religion, government, education, etc) over decades. For some strange reason, healthcare continues to present a "just trust us" arrogance. By providing transparent emergency service pricing, health systems can offer a justification for their requested trust. Transparent emergency service pricing says to patients "you can trust that we will treat you fairly" even when "you're over a barrel". Patients are able to confirm with data that the price charged is the same for all similar patients and it provides the ability for patients to see competitive pricing after the fact which confirms in the patient's mind that the site of care was at least reasonably within the market rate.
Next step beyond price transparency...real quality measures that are visible to patients.