Healthcare groups give thumbs down to hospital price transparency rule

CMS finalized a price transparency rule Nov. 15 that requires hospitals to disclose negotiated rates with insurers beginning in 2021. The federal government also issued a health plan transparency proposal that would require insurers to share price and cost-sharing information with members before treatment.

The proposal was panned by healthcare groups that support price transparency in general but oppose the Trump administration's approach.

Below are four reactions:

Editor's Note: Responses were lightly edited for length.

Beth Feldpush, DrPH, senior vice president of policy and advocacy for America's Essential Hospitals 

"Posting negotiated rates will not benefit consumers, adds an administrative burden that competes for resources with patient care, and can harm competition and drive up prices. These policies undermine hospitals' ability to negotiate equitable payments while giving consumers little actionable information with which to make informed care decisions."

Blue Cross Blue Shield Association President and CEO Scott Serota

"As the Centers for Medicare and Medicaid Services noted in the proposed rule, the publication of negotiated rates for medical services may have negative, unintended consequences — including price increases — as clinicians and medical facilities could see in the negotiated payments a roadmap to bidding up prices rather than lowering rates."

Federation of American Hospitals President and CEO Chip Kahn 

"This final regulation on hospital transparency fails to meet the definition of price transparency useful for patients. Instead, it will only result in patient overload of useless information while distorting the competitive market for purchasing hospital care.

"Beyond these patient concerns, the fact is that this regulation exceeds the administration’s authority, and we plan on joining with hospitals to file a legal challenge."

Joint statement from the American Hospital Association, Association of American Medical Colleges, Children's Hospital Association and Federation of American Hospitals 

The proposal "is a setback in efforts to provide patients with the most relevant information they need to make informed decisions about their care. Instead of helping patients know their out-of-pocket costs, this rule will introduce widespread confusion, accelerate anticompetitive behavior among health insurers, and stymie innovations in value-based care delivery."


More articles on healthcare finance: 

CMS unveils plans to resolve overcharges by Medicare Advantage insurers
Hospitals push for climate resiliency but face financial barriers, report shows
HealthPartners eliminating 75 jobs amid Medicare revenue decline

Copyright © 2024 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.


Featured Whitepapers

Featured Webinars