The Trump administration unveiled a wide-ranging proposal on Friday requiring hospitals and insurers to give consumers more information about what their health care will cost - a rule meant to increase price transparency for patients shopping for coverage.
The administration invited stakeholder feedback regarding how to incorporate healthcare quality information into the price transparency proposals and whether health plans, in addition to providing information on out-of-pocket costs through internet-based tools, should also require insurers to make such information available through a standards-based application programming interface, which would make it easier for external software developers to develop applications that would leverage such information.
"Our goal is to give patients the knowledge they need about the real price of health care services", said Trump.
"This rule will introduce widespread confusion, accelerate anticompetitive behavior among health insurers, and stymie innovations", the American Hospital Association and three other major hospital groups said in a statement. The statement was signed by the American Hospital Association, the Association of American Medical Colleges, the Children's Hospital Association and the Federation of American Hospitals.
Speaking at a White House event, President Trump said consumers have a right to know what healthcare services will cost beforehand, so they can shop around.
Insurers, under the proposed rule, would have to disclose the rates they negotiate with providers like hospitals.
The Trump administration said the new policies would create an open and transparent health care system.
Requiring disclosure of negotiated rates, he said, could lead to price increases "as clinicians and medical facilities could see in the negotiated payments a roadmap to bidding up prices rather than lowering rates".
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The first rule would require hospitals to publish their prices publicly online - "everything from individual medical supplies to the total cost of common procedures", Trump said.
Earlier this year, the administration ordered drugmakers to include their prices in advertisements, but the industry sued and won a court ruling blocking the measure.
He cited research suggesting that hospitals have charged patients anywhere from $248 to $2,500 for the same MRI at the same hospital. The administration has appealed that ruling.
"American patients have been at the mercy of a shadowy system", said Alex M. Azar II, the secretary of health and human services, said in a news conference Friday. "Administration officials, employers and others have criticized hospitals and insurers for keeping the deals they strike a secret, making it challenging for patients to seek less expensive places to get care", writes New York Times reporter Reed Abelson.
"We may face litigation, and we feel we are on a very firm legal footing", said Azar, who emphasized the information is already being made public to patients on what is called an explanation of benefits form - but after they go to the doctor or get a medical treatment.
Azar cited some studies that show that when prices are disclosed, overall spending can go down because patients choose cheaper services. Implementing the changes is likely to cost hospitals less than 1% of their revenue, an administration official said according to CNBC. "Transparency should be achieved in a way that encourages - not undermines - competitive negotiations", Matt Eyles, head of the industry trade group America's Health Insurance Plans, said in a statement.
Today, "they just see a bill and a discount". It is an editorially independent program of the Henry J. Kaiser Family Foundation which is not affiliated with Kaiser Permanente.