New proposed Trump administration regulations aim to make how much hospitals charge patients more transparent—a continuation of federal Obama era initiatives to pull the curtain back on the notoriously opaque American health care system by making hospital service charges easily available online. But, as with the Obama administration efforts, questions remain on just how useful the hospital pricing information will be for average U.S. consumers.
The proposal from the Centers for Medicare & Medicaid Services (CMS) is part of its annual guidance for Medicare, the gigantic federal program that covers millions upon millions of elderly and disabled Americans. Its purpose is ambitious: To nudge American health care to more quality care and away from the fee-for-service model that rewards conducting more tests and services.
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“We envision a system that rewards value over volume and where patients reap the benefits through more choices and better health outcomes,” wrote CMS in its release. “While hospitals are already required under guidelines developed by CMS to either make publicly available a list of their standard charges, or their policies for allowing the public to view a list of those charges upon request, CMS is updating its guidelines to specifically require that hospitals post this information.” In English: The listing of these prices vis-a-vis Medicare would become mandatory and, the hope is, eventually spill over to other parts of the health industry.
The question is whether or not these proposed rules (which are still subject to change and a comment period from medical industry stakeholders) will do enough to shift the needle on high medical costs charged for mediocre service. Topline prices listed by hospitals—as with those claimed by drug makers—aren’t really the amounts necessarily paid by insurers or patients. Net prices are negotiated largely behind the scenes, so even mandating price disclosures may not inform sick Americans how much they’ll actually pay out-of-pocket and which hospitals provide more bang for the buck.