The word in a nutshell is “transparency” and it may soon become a fact of life for hospitals across the nation according to The Centers for Medicare and Medicaid Services (CMS).
On Monday CMS proposed a regulation that would require hospitals to disclose the prices that are negotiated with insurance firms, which would then be passed to the consumer (the patient).
The new proposal is in keeping with the President’s executive order signed in June, directing the Department of Health and Human Services (HHS), which CMS is part of, to create rules increasing transparency in health care pricing.
HHS Secretary Alex Azar said in a statement; “President Trump has laid out a clear vision for healthcare: a patient-centered system that puts you in control and provides the affordability you need, the options and control you want, and the quality you deserve.”
Adding, “Under this proposal, hospitals will finally have to make their real, negotiated prices known to patients, enabling patients to shop among providers.”
Hospitals under the new proposal would face a $300 per day fine if they fail to comply in disclosing negotiated prices with patients.
According to CNBC, the administration already compels hospitals to publish the sticker prices of procedures and other services; however, patients will now also have access to the prices their insurance plans pay.
The new regulation is scheduled to go into effect as early as January, if finalized after a public comment period ending in September.
As predicted, the hospital and insurance industries are pushing back against the proposal.
Matt Eyles, president, and CEO of America’s Health Insurance Plans, said in a statement according to CNBC. “Publicly disclosing competitively negotiated, proprietary rates will push prices and premiums higher — not lower — for consumers, patients, and taxpayers.”
However, Cynthia A. Fisher of Patient Rights Advocate said her organization applauded “the Administration’s bold step to deliver real price transparency in healthcare to the American public.”
Adding, “Patients need to see real prices to make their healthcare decisions. Empowered with price and quality information, patients and their employers will be able to shop and ultimately drive down the costs of care and coverage. With this measure, healthcare will function like other competitive markets such as groceries, travel, and retail.”
According to CMS roughly 6,000 hospitals taking Medicare patients would be affected by the new regulation.
The President as been an advocate for transparency regarding healthcare issues, and has issued several executive orders to that effect. However some instances they simply haven’t panned out as desired. White House spokesman Judd Deere confirmed earlier in July that one such case was the so-called “rebate-rule” proposal, which encompassed the President’s drug pricing plan.
The President had signed the executive order in June calling it “the opposite of Obamacare,” in that it directs the Department of Health and Human Services to create rules that will increase transparency in health care pricing arena, for the patent.
“We will empower patients with the information they need to search for the lowest cost and highest quality care,” Trump said, adding the executive order’s goal is to “put American patients first.”
“People have no idea how big it is. Some people say bigger than health care itself. … For too long it’s been virtually impossible for Americans to know the real price and quality of health care services and the services they receive,” Trump continued.