Saturday, 17 August, 2019

Trump Signs ‘Bigger Than Health Care’ Order Requiring Hospitals to Disclose Charges

1333098_web1_AP19175735844747 Trump signs executive order to address sticker shock health care costs
Anna Jefferson | 27 June, 2019, 02:55

The White House released an executive order Monday afternoon meant to require insurance companies, doctors, and hospitals to give patients more information about precisely what their care will cost before they get it.

The order directs agencies to draw up rules requiring hospitals and insurers to make public more information on the prices they hammer out in contract negotiations. "And health care costs would rise for all Americans as a result", America's Health Insurance Plans CEO Matt Eyles said in a statement responding to price transparency plans. "We will empower patients with the information they need to search for the lowest cost and the highest quality care".

It directs HHS to issue a rule requiring hospitals to disclose "in an easy-to-read, patient-friendly format" prices that reflect what patients and insurers actually pay.

Q: What does the order do?

- A plan to pull together the government's various health care quality rating systems for hospitals, nursing homes, and Medicare Advantage plans.

When employers get a clear view of health-care prices, they're sometimes able to drive them down. "That's what's driving all of this".

When armed with accurate information, patients can often identify savings by shopping around for healthcare services.

Hospitals, insurers and other providers in the health care industry are already preparing to oppose disclosing their contracted rates, which they say will do more harm than good.

Exactly how aggressive the requirements will be, however, is yet to be determined.

Hospitals and insurers have both argued that forcing them to disclose negotiated prices could have the paradoxical effect of increasing costs, not lowering them.

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A senior administration official at the press briefing said details about whether the rates would be aggregated or relate to individual hospitals would be spelled out only when the administration puts forward proposed rules to implement the order later this year.

It's unclear how the executive order would be enforced - it's likely to face some blowback from many insurers and hospitals. Many hospitals, however, are staffed by doctors who are not directly employed, or laboratories that are also separate. Price doesn't necessarily drive people in the same way that it would if you were shopping for a vehicle or groceries.

Q: How could consumers use this information?

But that could prove hard if the rates were not fairly hospital-specific, or if they were not lumped in with all the care needed for a specific procedure or surgery.

His administration urged Congress to pass a "gag clause" ban, so pharmacy customers know if they can pay less with cash than with their insurance, and it is ordering drug companies to disclose list prices in TV ads. Coupled with a lower-premium, high-deductible insurance plan, the accounts can be used to pay out-of-pocket costs for routine medical exams and procedures. Because of varying levels of coverage by insurance companies, the same procedure could cost one patient a couple hundred dollars, while costing another a thousand or more.

This executive order is the latest in a series of moves from the Trump administration on health care price transparency recently.

"Real steps must be taken to lower prices for health care on everything from drug prices to medical procedures", he said.

The short answer is maybe.

"It's pretty much going to blow everything away, Alex, as we've discussed", Trump said to HHS Secretary Alex Azar. "(It) contains the list price ... the negotiated rate ... and what your out-of-pocket is", Azar said. This would put consumers, and patients in the driver seat.

The policy does have natural appeal from a consumer standpoint, experts said.

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