The Determinants of Targeted Transparency in the US States: The Roles of Targeted Organizations and State Fiscal Environments

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.