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Giving Patients the Tools to Hold Providers Accountable – The Transformative Potential of HealthCost Transparency

Giving Patients the Tools to Hold Providers Accountable – The Transformative Potential of HealthCost Transparency

By Jerome Babate
on January 31, 2025

The recent Health Systems Research (HSR) 2024 Symposium in Nagasaki,
Japan
, brought together some of the brightest minds in global health to
tackle the most pressing challenges of our time. Among the many
highlights was the recognition of winners from the Health Systems Global
(HSG) Thematic Working Group on Action on Accountability and
Anti-corruption for the SDGs (TWG AAA)
Crowdsourcing Competition. This
global initiative was not just a platform for ideas but a call to action
for innovative solutions that could redefine transparency and
accountability in healthcare.

It was both humbling and exhilarating to stand among the winners,
representing a vision that originated from the Philippines—a vision that
seeks to tackle the persistent issue of healthcare corruption through a
community-driven initiative called HealthCost Transparency (HT). My case
study addressed a fundamental problem in the Philippine healthcare
system: the lack of cost transparency, particularly in both  private and public
hospitals.


The problem is stark. Patients walk into healthcare facilities without
any clear understanding of what their medical services will cost. They
are often blindsided by hidden fees, inflated bills, and arbitrary
pricing, leaving them vulnerable to financial exploitation. Even the
Philippine Health Minister acknowledged the severity of the issue,
stating, “The problem with our health system is that the costs vary.
It’s been a long time since we started pushing for private hospitals to
post a table of their standard fees on their facilities, so their
patients would know the possible costs from the moment they enter the
facility
.”

HealthCost Transparency was developed as a response to this challenge (an impetus to the crowdsourcing competition initiated by TWG AAA). It is built on four key pillars that collectively create a system where
transparency is not an afterthought but the foundation. Standardized
cost charts are at the heart of the initiative, providing patients with
clear, upfront information about the cost of medical procedures,
medications, and services. These charts are not just for display but are
prominently featured in healthcare facilities and made available online,
ensuring patients can access this information at any time.

But transparency alone is not enough. That is why HT incorporates
community-driven mechanisms, such as patient committees. These volunteer
groups are empowered to monitor healthcare providers, audit medical
bills, and report discrepancies to independent ombudsmen. This
grassroots approach fosters accountability and ensures that oversight is
not confined to government institutions but involves the people who are
most affected by corruption.

Feedback mechanisms are another cornerstone of HT. Patients are provided
with hotlines and online platforms where they can report irregularities
or share their experiences. This creates a direct and accessible channel
for real-time communication between patients and oversight bodies,
helping to build trust and encourage systemic change.

Finally, collaboration is key. HT brings together healthcare providers,
government agencies, and community organizations to create a culture of
accountability. It is not about pointing fingers but about building a
system where everyone has a role to play in ensuring transparency.

More than just an innovation, it’s a movement

The prize-giving ceremony at HSR 2024 was a moment of validation for
this innovation. Standing on stage in Nagasaki, a city known for its
history of resilience, I was reminded that healthcare systems can be
resilient, too. The recognition was not about celebrating an individual
or an idea but about affirming the collective potential of communities
to create systemic change.

This innovation is particularly relevant for PhilHealth, the
Philippines’ national health insurance system, which has faced
significant challenges, including fraud, inefficiencies, and a lack of
transparency
. HealthCost Transparency directly addresses these issues.
By standardizing costs and empowering communities to monitor and report
irregularities, HT aligns with PhilHealth’s goals of improving
accessibility and accountability. It provides a blueprint for how
national health systems can rebuild trust and deliver equitable care.

What makes HealthCost Transparency especially powerful is its
simplicity. At its core, it is about giving patients the tools to
understand their healthcare costs and the channels to hold providers
accountable. But this simplicity belies its transformative potential.
Imagine a healthcare system where no patient is surprised by hidden
fees, where communities work together to ensure fairness, and where
providers are incentivized to maintain ethical practices. This is not
just a vision for the Philippines—it is a model for healthcare systems
worldwide.

The experience at HSR 2024 extended far beyond the prize itself.
Engaging with global health experts and practitioners, exchanging ideas,
and receiving constructive feedback were invaluable. These interactions
not only refined the approach but also illuminated the potential
pathways for scaling and implementation.

Indeed, HealthCost Transparency is more than an initiative; it is a movement
toward a healthcare system that prioritizes equity and trust. Its
principles—transparency, community engagement, and collaborative
oversight—are universal. The problem of healthcare corruption is not
unique to the Philippines. Across the globe, patients face similar
challenges, and HT offers a solution that is both scalable and
impactful. This is not just about tackling corruption; it
is about ensuring that every individual, regardless of their
circumstances, has access to fair and transparent healthcare.

As I reflect on this journey, I am reminded of the words shared by my
Filipino colleague: “Health systems are only as strong as the
accountability mechanisms that underpin them.” This idea lies at the
heart of HealthCost Transparency. Accountability is not just a policy—it
is the foundation of trust, equity, and sustainability in healthcare.



Professor Dina Balabanova & Jerome Babate

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