Trump administration plans to require hospitals to list ‘shoppable’ prices

Hospitals could be required to provide prices in an “easy-to-read, patient-friendly format” before they provide services to patients under rules that will be proposed in an executive order signed by President Donald Trump.

In an announcement held by White House officials Monday morning, Department of Health and Human Services (HHS) Secretary Alex Azar said the order would “put American patients in control and address the fundamental drivers of high American healthcare costs.”

“Patient empowerment, of course, requires transparency around price and quality,” Azar said.

The executive order included several major components, Azar said. Among them:

• 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.
• The order requires HHS to put forth a proposal to require providers and insurers to provide patients with information about out-of-pocket costs before they receive healthcare services.
• It calls for the administration to lay out a road map for consolidating quality measures across all federal healthcare programs.
• It calls for the administration to expand access to de-identified healthcare claims data to provide data sets for supporting researchers in identifying opportunities for improving American healthcare.
• It directs the Department of the Treasury to expand consumers’ ability to take advantage of health savings accounts (HSAs) and other medical accounts by expanding the range of services for which HSA dollars can be used. It also requires HHS to work with other departments to determine how to better address surprise billing and other barriers to transparency and “shoppability in healthcare.”

Officials did not give a timeline for the plan, which is almost certain to draw ire across the hospital industry over concerns of competition as well as complexity. Administration officials acknowledged those concerns and said they would be putting out regulations focused on requiring hospitals to disclose “information based on negotiated rates” and to make it publicly available.

However, they said the level of detail that would be required to comply will be made available as part of the proposed rule-making process. The administration will also include industry input, the officials said.

That said, they indicated the requirement would need to result in prices for common or “shoppable” items and services to be available in an “easy-to-understand” customer-friendly format.

“Every time any one of us goes to a doctor or a hospital, within a couple of weeks in our mailbox arrives an explanation of benefits. That explanation of benefits contains the list price for the procedure you got, what the negotiated rate between the insurance plan and the provider and what your out-of-pocket is,” a senior administration official said. “The rates are there. This is not some great state secret out there. What we’re saying is, you’ve got the right to know the information before you get the service.”

https://www.fiercehealthcare.com/hospitals-health-systems/trump-administration-plan-to-require-hospitals-to-list-shoppable-prices