Jan. 11, 2019
Dive
Brief:
- CMS
administrator Seema Verma said Thursday the agency has no
means of enforcing its new price transparency rule, which mandates
hospitals post standard charges online in a machine-readable format.
- Seema told
reporters said that while "there are no penalties at this time,"
CMS is asking in a request for information what
the enforcement mechanism for the rule should be. There is no timeline for
penalty implementation, she said.
- CMS also does not know — or would
not make it known — how many hospitals are currently complying with the
rule. Rather, Verma said, "it is the expectation that all of them
will comply."
The
new rule, which went into effect on the first day of the year, was considered
by many to be in an inadequate first step toward price transparency. It doesn't
require posting any more information than hospitals already provide the public
by law. Essentially, it mandates hospitals post that information online in
spreadsheets.
Some
have criticized hospitals for burying the pricing information on their
websites. Ascension, one of the nation's largest hospital operators, has a
one-stop shop pricing website, which lists
cost information for each of their hospitals across the country — but it's hard
to find.
The
company said it supports price transparency and is in compliance with the
regulation. However, it noted the pricing can be confusing for
patients. "Pricing does not reflect our financial assistance and
charity care policy, and could vary by individual patient and by
facility," Ascension said in a statement to Healthcare Dive. "We
encourage those who are seeking or scheduling care to contact us for the
pricing that is right for you."
Other
critics have said the price
listing can be misleading for patients, and chargemaster information isn't
particularly helpful because hospitals rarely get paid on the sticker price.
Still,
Verma was adamant that the rule is an "important first step"
toward lowering costs by getting patients the information they need to compare
prices. If patients can't compare costs, she said, competition is stifled.
Consumers have been "shut out" of healthcare when they should be the
"driving change."
Studies
have shown, however, that Americans aren't wild about shopping for healthcare.
A Health Affairs report found just 13% of respondents responsible
for cost-sharing in their last healthcare encounter sought cost information
before receiving care. Only 3% compared prices of different providers.
That's
not likely to change any time soon. According to a recent JAMA Internal Medicine
report, hospitals are not improving when it comes to providing price
estimates for procedures. The study's authors also said there is "sobering
evidence" that the level of price transparency is actually getting worse.
The percentage of hospitals that were unable to provide price information
jumped from 14% to 44% between 2012 and 2016.
"We
are just getting started as we work to increase pricing transparency,"
Verma said Thursday. The solution, she added, isn't as simple as revealing
prices.
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