White House to Issue Healthcare Price Transparency Next Week
The White House is set to unveil its approach to healthcare price transparency in a forthcoming executive order.
Source: Thinkstock
By - The Trump Administration will issue an executive order on healthcare price transparency on Monday, according to the Wall Street Journal.
Stephanie Armour reports that the Trump Administration “will direct federal agencies to initiate regulations and guidance that could require insurers, doctors, hospitals and others in the industry to provide information about the negotiated and often discounted cost of care.”
Payers and providers have already voiced opposition to previous attempts at healthcare price transparency, with 91 percent of hospitals reporting concerns over the implementation of a CMS rule earlier this year requiring these providers to publish their prices publicly.
Those concerns, however, are not holding back the executive branch from moving forward.
“It is my hope you see price transparency and interoperability as marketing opportunities, not a competitive disadvantage,” CMS Administrator Seema Verma told attendees of the Federation of American Hospitals 2019 Public Policy Conference in March.
“I believe that a key reason healthcare costs continue to skyrocket is the fact that healthcare prices are largely hidden from patients,” she said of the price transparency requirement. “Simply put, hidden pricing means healthcare providers don’t have to compete on cost. Transparency creates competition, and competition keeps prices down, because patients can shop.”
While large trade groups have resisted the federal government’s plans, claiming that patients want to know their financial responsibility rather than negotiated prices, a large number of physicians have expressed support for the Trump Administration’s work:
The executive order has the backing of a number of doctors who on Thursday urged the administration to push ahead on disclosure of prices. "We, signing independently, are 3,969 physicians who make caring for patients our professional priority," according to a letter Thursday from doctors and doctor practices to Mr. Trump and viewed by The Wall Street Journal. "We are distressed and disheartened by how America's healthcare system is failing them."
The WSJ report notes that the White House has looked to numerous bits of legislation — namely the 21st Century Cures Act, the Affordable Care Act, and even HIPAA — for the authority to issue its orders.
“It’s unclear how aggressive the order will be because of the pushback from industry, and some White House advisers who have urged a more measured approach,” writes Armour.
But the White House isn't the only branch of the federal government addressing healthcare spending.
Earlier this week, the Senate Committee on Health, Education, Labor, and Pensions (HELP) sent the Lower Health Care Costs Act to the full Senate floor after having adopted the benchmark pricing solution for surprise medical billing. (The Senate HELP committee solicited feedback on three proposals for addressing surprise billing but received no consensus.)
“This legislation will reduce what Americans pay out of their pockets for health care in three major ways,” said bill co-sponsor Senator Lamar Alexander (R-TN). “First, it ends surprise billing; second, it creates more transparency — you can’t lower your health care costs until you know what your health care actually costs. And third, it increases prescription drug competition to help bring more lower-cost generic and biosimilar drugs to patients. I look forward to working with my colleagues in the Senate health committee to mark up this legislation next week before sending it to the full Senate for consideration.”
Other senators are actively working on similar proposals, such as the STOP Surprise Medical Bills Act. The latter comprises three provisions for prohibiting surprise billing for emergency and non-emergency care, limiting a patient’s out-of-pocket spending to the in-network cost for out-of-network care.
“Patients should be the reason for the care, not an excuse for the bill," said Sen. Bill Cassidy, MD (R-LA). “We have worked for almost a year with patient groups, doctors, insurers and hospitals to refine this proposal. This is a bipartisan solution ensuring patients are protected and don’t receive surprise bills that are uncapped by anything but a sense of shame.”
One way or another, the costs of healthcare will see the light.
