Feb 11-15: Transparency Push Challenges Hospitals

February 8, 2019 8:19 am

CMS is considering a range of additional transparency requirements.

Feb. 7—As hospitals work to meet increasing federal price transparency requirements, a senior Trump administration official said they need to move beyond those requirements.

Alex Azar, secretary of the U.S. Department of Health and Human Services (HHS), this week responded to the concern of hospital leaders that the latest federal transparency requirement would not be helpful to patients. The policy required that by Jan. 1 hospitals post their chargemasters online and in a machine-readable format.

“We’re well aware that could be an issue, and that this is just step one around hospital price transparency,” Azar said. “But to the extent that hospital list prices aren’t useful information for the patients they serve—well, hospitals are the ones in the best position to do something about it.”

It was unclear what Azar expected hospitals to do, but he said the machine-readable requirement may allow the charge data to be incorporated into apps that patients can use without having to go to the hospital’s website.

Some hospitals have managed to exceed that mandate in ways that provide more effective price transparency.

Azar was not the only policymaker pushing back recently on hospitals’ concerns over the requirements.

Rep. Larry Bucshon, MD, (R-Ind.) told a recent health policy meeting in Washington, D.C., that “the one thing that is lacking a lot in the hospital space is that none of them really know what things cost.”

“So far, they have basically released information that is basically not decipherable by normal people, and that was not accidental,” said Bucshon, who is a former hospital administrator.

He also noted that a similar requirement of hospitals in California did not reduce healthcare costs.

“You know why? Because people go, ‘Wow, they must be better because it costs more for people to go there,’” Bucshon said. “So just publishing charges alone doesn’t do anything. You have to have risk-stratified quality data that the public can understand, which is a difficult proposition.”

Bucshon was not sure how such information could be provided, but he too put the onus on hospitals.

“At some point we’re going to have to figure out how to justify these dramatically higher costs coming out of hospital systems,” Bucshon said, referring to data he says show the number of administrators increasing while the number of physicians remains flat.

“The business side of health care is causing most of this price increase,” Bucshon said.

More Requirements?

At the same meeting, Doug Badger, a senior fellow at the Galen Institute, suggested a new mandate to require hospitals to provide individualized price estimates at patients’ request. The estimate would need to include both physician and facility fees.

Along those lines, the Centers for Medicare & Medicaid Services (CMS) last year requested public feedback on what “changes are needed to support greater transparency around patient obligations for their out-of-pocket costs; what can be done to better inform patients of these obligations; and what role providers should play in this initiative.”

Separately, CMS has requested comment on similar charge transparency requirements for hospital outpatient prices and for physician payments.

CMS is also considering whether to publicize any “hospital noncompliance” with its transparency requirements, as well as undertaking “additional enforcement mechanisms.”

Monday, Feb. 11

Workshop by the National Academies of Science, Engineering and Medicine titled “Developing and Sustaining an Effective and Resilient Oncology Careforce” in Washington, D.C. Learn more.

HIMSS19 Conference and Exhibition in Orlando (through Feb. 15). Learn more.

Deadline to submit comments to the Department of Health and Human Services’ Office for Civil Rights on potential changes to the Health Insurance Portability and Accountability Act rules to promote coordinated, value-based care. Learn more.

BIO CEO & Investor Conference in New York City (through Feb. 12). Learn more.

Tuesday, Feb. 12

Webinar by the Centers for Medicare & Medicaid Services (CMS) and the Joint Commission as part of the “Joint Commission Pioneers in Quality eCQM Expert to Expert Webinar Series.” Learn more.

Hearing by the Senate Health, Education, Labor and Pensions Committee titled “Managing Pain During the Opioid Crisis.” Learn more.

Conference call by CMS titled “Home Health Patient-Driven Groupings Model.” Learn more.

Web briefing by the Health Care Cost Institute on its annual Health Care Cost and Utilization Report. Learn more.

Member meeting of the Health Enhancement Research Organization Think Tank in San Antonio. Learn more.

Webinar by the American Hospital Association’s (AHA’s) Hospitals Against Violence initiative titled “Trafficking of Children for Labor and Sex: The Health Care Professional’s Response.” Learn more.

Wednesday, Feb. 13

Hearing by the House Energy and Commerce Committee’s Subcommittee on Health titled “Strengthening Our Health Care System: Legislation to Reverse ACA Sabotage and Ensure Pre-Existing Conditions Protections.” Learn more.

Webinar by CMS titled “Falls Prevention for Older Adults.” Learn more.

Webinar by AHA’s Society for Healthcare Strategy & Market Development titled “Futurescan 2019-2024: Leading Through Times of Change.” Learn more.

Webinar on the American Board of Internal Medicine’s Trust Practice Challenge, which seeks to address the “trust gap” in health care. Learn more.

Webinar by the National Academy of Medicine titled “NAM Action Collaborative: Countering the U.S. Opioid Epidemic.” Learn more.

Thursday, Feb. 14

Conference call by CMS titled “New Part D Opioid Overutilization Policies.” Learn more.

Webinar sponsored by America’s Health Insurance Plans titled “A Data-Driven Analysis: CMS 2020 Advance Notice.” Learn more.


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