Five things to know:
1. While patient advocates have come out in support of the proposal, hospitals and insurers are raising questions about whether the Trump administration has legal authority to require their negotiated prices be released.
2. The potential change, which the groups argue is too complex, could also require them to publish prices that mean little to patients, leaders like Tom Nickels, executive vice president of the American Hospital Association, said.
3. In a March 8 statement, Mr. Nickles said: “What patients really want to know is what their out-of-pocket costs will be. Insurers are the only ones that have this information. Insurers need to make this information available to hospitals so they can share it with their patients.” He continued: “Disclosing negotiated rates between insurers and hospitals could undermine the choices available in the private market. While we support transparency, this approach misses the mark.”
4. While the regulation may mean hospitals face pressure from insurers to lower prices, revealing the negotiated prices could also put pressure on insurers if hospitals find they’re getting reimbursed much less than their competitors, according to The Wall Street Journal.
5. The insurance trade group America’s Health Insurance Plans told the publication it is still reviewing the proposal.
More articles on payers:
5 must-reads on payer-provider relationships
State of the payer market: the growing need for infrastructure and operations
8 recent lawsuits involving payers
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