CMS' new price transparency rule could be a "game-changer for healthcare," according to a new op-ed by Elisabeth Rosenthal, MD, former New York Times correspondent and editor-in-chief at Kaiser Health News.
The Trump administration's new rule, which took effect Jan. 1, requires hospitals to publish their standard charges on the internet. They must present the information in a machine-readable format that can be easily imported into a computer system and update the information at least annually.
Despite concerns the prices will be more confusing than helpful for healthcare consumers — an issue addressed by CMS Administrator Seema Verma — Dr. Rosenthal wrote, "Don't dismiss the lists as useless."
"Think of them as raw material to be mined for billing transparency and patient rights," she wrote. "For years, these prices have been a tightly guarded industrial secret. When advocates have tried to wrest them free, hospitals have argued that they are proprietary information. And, hospitals claim, these rates are irrelevant, since — after insurers whittle them down — no one actually pays them. Of course, the argument is false, and our wallets know it."
While posting chargemasters online will not solely reform the healthcare system, Dr. Rosenthal thinks it may make hospitals rethink what they charge for services.
"Maybe, just maybe, a hospital will think twice before charging a $6,000 'operating room fee' for a routine colonoscopy if its competitor down the street is listing its price at $1,000. Making this information public should bring list prices more in line with what is actually paid by an insurer, a far better measure of value," she wrote.
For the full op-ed, click here.
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