The Centers for Medicare and Medicaid Services (CMS) has proposed an update to price transparency guidelines for hospitals. The newly proposed rule would require hospitals to post a list of their standard charges online. Hospitals are already required to provide their standard charges to the public upon request, but the proposed update to the rule specifically requires the list of charges to be available to patients via the internet.
CMS Administrator, Seema Verma commented, “These proposed rules are just the beginning of our plan to move to a value-based system, and as we make this transition our administration is empowering patients, because patients should be at the center of cost and quality decisions, and have the information they need to make decisions for themselves and their families.” U.S. Health and Human Services (HHS) Secretary Alex Azar added that, “The reforms proposed by CMS bring us one step closer to a modern healthcare system that delivers better care for Americans at a lower cost.”
CMS is asking for comments from providers and the public to determine what price transparency information is the most useful to patients, and how providers can make relevant pricing information easily accessible to the public so that consumers can compare providers. Also, during the comment period, CMS administrators are seeking to learn more about the challenges hospitals face when informing patients of their financial responsibility for healthcare services.
Complying with price transparency rules has proved complicated for providers, because gross charges from a healthcare provider do not reflect what the patient will actually owe after insurance contractual adjustments, self-pay discounts or any charity deductions are calculated. However, today’s healthcare consumers want price transparency, and providers who take the initiative to make basic charges available online, may be ahead of the game.
Hollis Cobb has been assisting clients by providing staff to field phone calls from patients seeking to compare prices for healthcare services. Our staff accesses our clients’ price estimator tools and other systems necessary to help patients determine their out-of-pocket expenses for the services they are considering. After calculating contracted rates based on each patient’s insurance plan, and the expected contractual adjustments and payments, our staff is able to provide patients with cost estimates. Clients struggling with lack of staff due to budget constraints have benefitted from our staffing program as they strive to meet the public’s demand for price transparency.