CMS looks to develop consumer comparative pricing portal

• CMS has begun searching for a company capable of building and maintaining a digital platform for comparing healthcare prices.
• The notice seeks information from organizations with specific experience in healthcare price comparisons and online bidding for healthcare services and interactions between consumers and providers.
• Depending on the responses, CMS could issue a formal request for proposals for a company to develop an online comparative pricing tool.

CMS has been pressing hospitals to be more transparent in their pricing of procedures and services. The agency’s final rule on the Inpatient Prospective Payment System, issued earlier this month, requires hospitals to post a list of their standard charges online in a “readable machine format” and update the information at least once a year.

While the transparency provision only cements what CMS already requires of hospitals, a supplementary request for information seeks input on further pricing transparency.

In addition to comparative pricing and online bidding, CMS wants a company experienced in handling personally identifiable information and protected health information, as well as transmitting and storing healthcare supplier information. Potential contractors should be capable of using healthcare price comparison data and bid or auction data for healthcare procedures, the Sources Sought notice says.

“Responding organizations should have specific experience supporting provider/supplier pricing and transparency efforts in the healthcare exchange and/or commercial insurer health care market who currently offer support for the development and maintenance of web-based price comparison tools, bidding systems, and applications,” the notice adds.

Creating a mechanism for consumers to comparison shop for healthcare goes a step beyond just requiring hospitals to publish basic charges online. A handful of states have launched initiatives to help consumers find affordable healthcare online. Maryland’s Wear the Cost program lets consumers compare prices for four common nonemergency procedures at hospitals and was recently expanded to include price and quality data based on commercial insurer data from 2015 and 2016.

Still, studies have shown Americans aren’t good about shopping for healthcare. In a study published in Health Affairs, just 13% of respondents responsible for cost-sharing in their last healthcare encounter sought cost information before receiving care and only 3% compared prices of different providers.

https://www.healthcaredive.com/news/cms-looks-to-develop-consumer-comparative-pricing-portal/531280/