Abstract

Despite recent interest in transparency, not much scholarly attention has been paid to the determinants of government operation of targeted transparency policies, mandating targeted organizations including corporations or private entities, to disclose data to address market failures. This study explores how targeted organizations and state financial environments affect state operation of All-Payer Claims Databases (APCDs), a targeted transparency policy at the U.S. state level. The establishment and operation of APCDs is a recent state initiative to collect and utilize comparable health data on prices and quality measures from non-governmental actors as well as governmental actors, which can contribute to reducing information asymmetry between state health policymakers and providers and to constrain health care expenditures. We found that the operation of APCD was affected by insurance market competition and enrollment, and state financial environments, as well as by state political context and service demands. Especially, this study encourages future researchers to study how insurers as targeted organizations shape the state operation of the price transparency strategy.

摘要

尽管最近对透明度产生了兴趣，但学术界并未过多关注政府实施有针对性的透明度政策的决定因素，即强制包括公司或私人实体在内的目标组织披露数据以解决市场失灵问题。本研究探讨了目标组织和州金融环境如何影响全付款人索赔数据库 (APCD) 的州运营，这是美国州一级有针对性的透明度政策。APCDs 的建立和运作是最近的一项国家举措，旨在收集和利用来自非政府行为者和政府行为者的有关价格和质量措施的可比健康数据，这有助于减少州卫生政策制定者和提供者之间的信息不对称并限制医疗保健支出。我们发现，APCD的运营受到保险市场竞争和招生、国家金融环境、国家政治环境和服务需求的影响。特别是，这项研究鼓励未来的研究人员研究保险公司作为目标组织如何塑造价格透明度战略的国家运作。