CMS price transparency rule would address just 12% of health care spending

U.S. health care costs are out of control. Among the myriad attempts to address this are several orders and initiatives by the Trump administration, the most notable being a requirement that hospitals post list list prices for services starting in 2021.

While hailed as a major step forward for price transparency, there’s still skepticism about how effective the action will be. According to the Health Care Cost Institute, the actual services covered the order represented just 12 percent of total spending and 15.6 percent of out-of-pocket costs for those with an employer-sponsored health plan in 2017.

Related: Price disparities challenge ability of transparency executive order

Why so little? The order is restricted to “shoppable services,” or, according to the CMS, “a service package that can be scheduled by a healthcare consumer in advance.” This includes 70 services specified by the CMS, as well as an additional 230 of the hospital’s choosing.

The focus on shoppable services makes sense, as it empowers consumers to vet different options before committing to non-emergency procedures. As for a larger impact on health care costs? Probably not. As the Cost Institute notes, “While the amount of total health care spending that is shoppable is not trivial, it does limit the potential impact of consumer-focused initiatives.”

A better area of focus for employers and employees, their data suggests, is shoppable pharmacy costs, which, when added to shoppable medical services, added up to 36 percent of total spending in 2017.

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