The rule, finalized Thursday by the Centers for Medicare and Medicaid Services, is part of the Trump administration’s goal toward “value-based care,” which aims to reduce the costs of healthcare while improving outcomes.
Hospitals will be required to post the prices they charge for surgeries and other medical procedures online under a new Trump administration rule.
The rule, finalized Thursday by the Centers for Medicare and Medicaid Services, is part of the Trump administration’s goal toward “value-based care,” which aims to reduce the costs of healthcare while improving outcomes. Officials hope to be able to drive down costs by showing patients more information about what different medical procedures will cost, and at times encourage them to shop around.
Previously, CMS required that hospitals make the information available to anyone who asks for it. Under the new rule, hospitals will need to update the prices every year beginning Jan. 1, 2019.
“The agency is considering future actions based on the public feedback it received on ways hospitals can display price information that would be most useful to stakeholders and how to create patient-friendly interfaces that allow consumers to more easily access relevant healthcare data and compare providers,” CMS said in a statement.
The posted prices are different than what most patients and health insurance companies pay for care, because each insurer or government payer such as Medicare negotiates payments.
by Kimberly Leonard, The Washington Examiner
August 03, 2018
Really? So now I’ll be able to “Build and Price” my own spinal fusion surgery. How nice is this! I can shop around for the lowest “MSRP”. Of course, no one pays the MSRP. But that’s okay. The automobile manufacturers comply with the requirements to put it on the sticker. We can call this “PSRP” for “Provider Suggested Retail Price” and no one can pay it either.
I just see this as adding a layer of confusion and creating more discontent in society in general as people realize these prices don’t have any connection to reality. Those who can’t afford some type of medical insurance can’t pay for reasonable health care now. And posting prices is of no consequence to those who have the resources to pay for what they need.
If you think of medical procedures as a commodity, even in more regulated markets, the rich will still have all they want of the commodity when and where they want it as they do now. The other extreme of society that can’t afford it now will still just do without, or turn to the “black market”. There are black markets in medical care at both the top and bottom ends of society already. Neither of which are commonly discussed or talked about in the media very often.
So, what might society reasonably expect to gain in reality by having hospitals post prices online for medical procedures? I suggest the answer is nothing. The “have not’s” will still visit the emergency rooms to have splinters removed. The lesser known black market at the top of the food chain will be unaffected. And the vast majority of society may actually experience an increase in cost as measured in labor hours, due to an increase in costs to hospitals of maintaining, justifying, compliance and updating their online price lists.
And honestly my friends, once you’ve gotten to the point of your surgeon telling you that you need surgery for Spinal Stenosis, aren’t you going to a hospital where your surgeon exercises privileges? Does it really matter if a semi-private room across town is listed with a “PSRP” of $50 less per night?
This online price list idea appears to me to be nothing but an illusion in the collective minds of the administration. There are just too many unquantifiable, and in my opinion, irrelevant variables in this equation. We need better ideas, not more smoke.
The last time I had surgery, from the time I reported that day to the time I was put to sleep in the OR, I had nine people ask me what I was having done today. Great idea! Great safety net that doesn’t cost a penny.
Our local publicly funded hospital has a Quick Care facility in the main build just like others around the country do. The hospital is mandated to provide treatment based on medical necessity and not on ability to pay. I don’t know if the hospital requirements allow this or not, but if someone comes into the ER with a splinter in the finger, send them three doors down the outside wall to the Quick Care facility. Even if the entire ER staff is standing around having cookies and coffee. They may be experiencing a rare break, or you might be overstaffed.
In any case, no ER resources should be devoted to splinters. There may be some savings to be found here. A broken tree branch protruding from someone’s thigh, drop the cookies and move, a splinter, not hardly. I’m sure most publicly funded hospitals have similar issues.
Please Mr. President, no more smoke.
Dave
Greg,
Thank you for this very informative newsletter. Regarding the statements below:
“Officials hope to be able to drive down costs by showing patients more information about what different medical procedures will cost, and at times encourage them to shop around.”
“The agency is considering future actions based on the public feedback it received on ways hospitals can display price information that would be most useful to stakeholders and how to create patient-friendly interfaces that allow consumers to more easily access relevant healthcare data and compare providers,” CMS said in a statement.
The posted prices are different than what most patients and health insurance companies pay for care, because each insurer or government payer such as Medicare negotiates payments.”
I have always discussed the cost of medical care with doctors & hospital officials. I challenge the cost and compare with other providers. This is a very good reminder for us to be vigilant of the rising cost of health care. I have not seen a decrease in cost yet.