Putting Price Transparency into Perspective

• March 01, 2025

• Maria Nikol , Revelar Analytics LLC
• Jackie Selby , Epstein Becker & Green PC
• Karen Mandelbaum , Epstein Becker & Green PC

For almost 70 years, employers have been the primary source of health care coverage for Americans under the age of 65. Employers receive incentives for offering health insurance and other benefits to employees under the Internal Revenue Service (IRS) Tax Code. Originally, health insurance only covered hospital and surgical procedures; physicians were only reimbursed for the services they provided when patients were hospitalized, as hospitalists were not introduced until the 1990s.1 Outpatient services, like office visits, were not typically covered but also typically were not as costly as care delivered through the hospital. For many years, patients experienced few, if any, out-of-pocket expenses for services covered by insurance. When insurance coverage expanded to include outpatient services, the traditional-fee-for-service model caused a rapid increase in cost that employers are now sharing with employees. 

ARTICLE TAGS

• Regulation, Accreditation, and Payment Practice Group
• Government Reimbursement
• Health Insurance