CMS pushes price transparency for hospitals
A proposed new rule would require hospitals to publicly list their standard charges online in a machine-readable form.
As part of the proposed annual inpatient hospital rule, the Centers for Medicare and Medicaid Services is asking hospitals to take the initiative and disclose their prices to patients.
Modern Healthcare reports that under the proposed new rule, hospitals will not only have to publicly list their standard charges or give them to the public upon request—something they’re already required to do—but also post the information.
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A Washington Post report adds that, according to a health policy expert, the new requirement for hospitals “to publish their standard charges online in a machine-readable form that will help insurers and other organizations analyze them” might not be as helpful as getting insurers to help patients better understand how much of the bill they’ll have to pay themselves.
Another part of the proposed rule calls for changes in the so-called “meaningful use” program that encourages hospitals to improve electronic health records. Starting in 2019, hospital ratings will depend a lot more on how successfully they do this—not only will hospitals be required to share data in a portable format easy for patients to take to doctors or other health care facilities, failures could impact their Medicare payments two years later. That program is being renamed “promoting interoperability” to reflect the changes.
As Modern Healthcare explains, “The proposed rule encourages providers to use application programming interfaces that would allow patients to collect their health information from multiple providers and potentially incorporate all of their health information into a single portal, application or other software.”
The report says that it’s not clear whether the Department of Health and Human Services actually has the legal authority to obligate hospitals to post pricing data, or how tough it might be to do it when taking into account the technical nature of hospital billing practices.
“Given the inherent complexity of hospital billing, making prices easy to understand is clearly a lot easier said than done,” Shawn Gremminger, senior director of federal relations at Families USA and former staffer at America’s Essential Hospitals, is quoted saying in a tweet about the new policy.