The recent, high-profile Pennsylvania Health Care Cost Containment Council report showing wide disparities in reimbursements to hospitals in our region for cardiac surgeries -- regardless of the outcomes -- is a strong first step toward health-care transparency.

M. Christine Whipple is executive director of the Pittsburgh Business Group on Health (pbghcw@aol.com).

But employers who offer health-care benefits, as well as the employees who contribute to their health-care benefits, should be very concerned. In reading the report it appears that some providers are paid much more than others for the same medical services, regardless of how well they turn out. Confirming what many have suspected, this is not an encouraging finding for employers, who pay the lion's share of health-care costs for workers in the region.

For several years, the Pittsburgh Business Group on Health has been a leader in championing greater transparency, value and quality in health care. As an employer-led coalition with 64 members, ranging from Fortune 500 companies to small businesses and nonprofits, the coalition implements and supports quality initiatives, analyzes health-care data and provides forums for the exchange of ideas to deliver value and quality in health care and health-care benefits.

At a time when business, government and health-care leaders seek solutions for exorbitant health-care costs and greater transparency, it is alarming to learn the range of payments to providers in our region, despite the fact that there appears to be no difference in quality, as measured by death and readmission rates. The cost-containment council found that UPMC Presbyterian and UPMC Shadyside were paid an average of $38,403 for a coronary artery bypass graft surgery, which compares to reimbursements for the same procedure to West Penn Allegheny Health System of $25,184 and to Jefferson Regional Medical Center of $18,009.

Equally troubling is West Penn Allegheny's expression of shock at the discrepancies, not so much because, as a teaching system, it expects comparable reimbursement to UPMC, but because it has insinuated that it might use the cost-containment council report as leverage to negotiate higher reimbursement levels. This should be of grave concern to employers and employees.

In a free market, people do not willingly pay a premium for a product that they can get somewhere else for less money. Why should health care be any different, especially at a time when health-care spending in the United States has topped $2 trillion and is growing at a rate that outstrips inflation?

Regional employers continue to feel the effects of high health-care costs. A recent survey by Pittsburgh-based Cowden Associates reported that employers saw a 6.3 percent increase in health-care costs in 2006. While employees have taken on a greater share of these costs, employers recognize they have probably reached the limit in passing on further cost increases to their workers.

Employers and employees must demand to know what they get for the health-care dollars they spend, and providers should make it easy for them to find out.

With the cost-containment council report and a growing push by the Bush administration to gain private sector support for its transparency initiative, now is the time for employers to use their collective buying power to ensure that they receive high-quality health care at fair prices.

The Pittsburgh Business Group on Health's prescription-drug and health-care programs are examples of how a coalition can leverage its collective power to create well-managed programs that provide quality care and better prices. Our relationships with health-plan executives and business leaders give us a forum to be heard.

By coming together, employers can have greater influence on private-insurer/health- care-provider contract negotiations to ensure that cost increases are mitigated and that everyone knows how much they are paying and what they are getting in return.