All of which speaks to the huge need for more systemic changes around payment reform.

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But a recent study by Catalyst for Payment Reform found that only 11 percent of payments to hospitals or doctors are in any way dependent on good quality or safety.

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But thanks to competition from Castlight Health, Change Healthcare and others, they are getting better, says Suzanne Delbanco, executive director of Catalyst for Payment Reform, which represents large employers pushing for price transparency.

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