CMS price transparency effort falls short, Nebraska hospital CFOs say

A federal price transparency effort has good intentions but does not necessarily provide patients with the most useful information to make healthcare decisions, CFOs at Nebraska hospitals say, according to KETV NewsWatch7.

On July 29, CMS released a proposed rule that includes provisions resulting from a price transparency executive order signed this year by President Donald Trump. It would require hospitals to publish all "standard charges," including the hospital's gross charges and negotiated rates with payers for an item or service, online in a machine-readable format.

The proposed rule expands a current federal rule requiring hospitals to publish their chargemaster rates on the internet, but excludes negotiated rates with payers.

But hospital CFOs at Nebraska Medicine, Methodist Health System and CHI Health, all in Omaha, Neb., said the current federal rule requiring hospitals to publish their chargemaster rates can make things more confusing for patients, according to KETV.

"For the vast majority of our interactions with a patient, it's not relevant because we already have some type of contract that's going to be unique in the case of the insurance company," Jeff Francis, CFO of Methodist, told the station.

However, Jeanette Wojtalewicz, the CFO of CHI Health, told KETV providing the public with negotiated prices between insurance companies and hospitals may be more helpful for patients in determining a good out-of-pocket cost estimate. Blue Cross Blue Shield Nebraska also recommended that patients use insurance companies' pricing tools to identify their potential financial burden.

Hospitals, insurers, physicians and other healthcare stakeholders have until Sept. 27 to weigh in on the federal government's proposed rule requiring hospitals to publish negotiated rates with third-party payers.


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