{"id":39042,"date":"2022-12-31T19:32:07","date_gmt":"2022-12-31T19:32:07","guid":{"rendered":"https:\/\/www.brandon.ddtest.info\/multisite-test\/making-the-hospital-price-transparency-rule-a-reality-on-its-two-year-anniversary\/"},"modified":"2022-12-31T19:32:07","modified_gmt":"2022-12-31T19:32:07","slug":"making-the-hospital-price-transparency-rule-a-reality-on-its-two-year-anniversary","status":"publish","type":"post","link":"http:\/\/www.brandon.ddtest.info\/multisite-test\/making-the-hospital-price-transparency-rule-a-reality-on-its-two-year-anniversary\/","title":{"rendered":"Making the hospital price transparency rule a reality on its two-year anniversary"},"content":{"rendered":"<p> \n<\/p>\n<div>\n<p>New Year\u2019s Day marks the second anniversary of a federal\u00a0<a rel=\"noreferrer noopener\" href=\"https:\/\/www.cms.gov\/hospital-price-transparency\" target=\"_blank\">hospital price transparency rule<\/a>\u00a0that has the potential to substantially lower outrageous healthcare costs burdening patients, workers, businesses, and taxpayers. The Centers for Medicaid and Medicare Services recently\u00a0<a rel=\"noreferrer noopener\" href=\"https:\/\/www.cms.gov\/research-statistics-data-and-systems\/statistics-trends-and-reports\/nationalhealthexpenddata\/nationalhealthaccountshistorical\" target=\"_blank\">announced<\/a>\u00a0the nation spent $4.3 trillion on healthcare in 2021, nearly 20 percent of GDP and\u00a0<a rel=\"noreferrer noopener\" href=\"https:\/\/www.oecd.org\/els\/health-systems\/health-expenditure.htm\" target=\"_blank\">almost two times<\/a>\u00a0the developed-world average. The Biden administration can mark this occasion by committing to robustly enforce the rule to turn it into a reality for American healthcare consumers.\u00a0<\/p>\n<p>The rule addresses the root of exorbitant hospital prices: hospitals\u2019 opaque charging practices that blind consumers to prices, then blindside them with inflated bills they often never would have agreed to if prices were known upfront. It requires hospitals to publish their discounted cash prices and negotiated insurance rates by health plan. Armed with this information, consumers can survey well-documented wide price variations for the same care, even at the same hospital, to avoid price gouging and access care at fair market rates.\u00a0<\/p>\n<aside class=\"ad-unit ad-unit--mr1_ab\">\n<\/aside>\n<p>Robust price transparency can hold hospitals accountable for egregious overcharging such as\u00a0<a href=\"https:\/\/khn.org\/news\/mri-cost-price-comparison-health-insurance\/\" target=\"_blank\" rel=\"noreferrer noopener\">$5,000 MRIs<\/a>\u00a0and\u00a0<a href=\"https:\/\/www.healthcaredive.com\/news\/hospitals-price-transparency-spotty-compliance-swings-price\/596183\/\" target=\"_blank\" rel=\"noreferrer noopener\">$100,000 knee surgeries<\/a>\u00a0that cost\u00a0<a href=\"https:\/\/greenimaging.net\/mri\/\" target=\"_blank\" rel=\"noreferrer noopener\">$250<\/a>\u00a0and\u00a0<a href=\"https:\/\/surgerycenterok.com\/?procedure_category=knee#jump\" target=\"_blank\" rel=\"noreferrer noopener\">$18,000<\/a>\u00a0at cash-based centers, respectively. Employers and unions knowing pricing data will allow them to benefit from competition. Price discovery will usher in quality transparency.\u00a0<\/p>\n<p>Consider the union SEIU 32BJ, which saved\u00a0<a rel=\"noreferrer noopener\" href=\"https:\/\/fortune.com\/well\/2022\/12\/06\/americans-hospital-price-transparency-rule-congress-patients-cost-cynthia-fisher\/\" target=\"_blank\">$30 million<\/a>\u00a0on its health plan by shopping for care. It recently <a href=\"https:\/\/nypan.org\/about\/news-and-updates\/2021\/6\/17\/32bj-severs-ties-with-newyork-presbyterian\" target=\"_blank\" rel=\"noreferrer noopener\">dropped New York-Presbyterian Hospital<\/a> from its health plan after analyzing its claims data and determining the hospital was price-gouging its members. For example, the hospital\u00a0<a rel=\"noreferrer noopener\" href=\"https:\/\/nypost.com\/2022\/11\/25\/union-urges-eric-adams-to-stop-private-hospitals-jacking-up-procedure-prices\/\" target=\"_blank\">billed<\/a>\u00a0the plan an average of $10,368 for outpatient colonoscopies versus $2,185 at the city\u2019s public hospitals. Hospital price transparency can make it easier for other employers and unions to follow in SEIU 32BJ\u2019s footsteps and significantly reduce healthcare costs.\u00a0<\/p>\n<p>Unfortunately, the price transparency rule has been marred by widespread hospital noncompliance.<\/p>\n<p>A recent\u00a0<a href=\"https:\/\/www.patientrightsadvocate.org\/august-semi-annual-compliance-report-2022\" target=\"_blank\" rel=\"noreferrer noopener\">study<\/a>\u00a0by PatientRightsAdvocate.org finds that only 16 percent of hospitals nationwide are following it. Most are not publishing their prices broken down by health insurer and plan as required, and some post no prices at all.\u00a0<\/p>\n<p>By refusing to comply, hospitals are perpetuating a pricing scam that has saddled\u00a0<a href=\"https:\/\/khn.org\/news\/article\/diagnosis-debt-investigation-100-million-americans-hidden-medical-debt\/\" target=\"_blank\" rel=\"noreferrer noopener\">100 million Americans<\/a>\u00a0with healthcare debt. This patient misery funds hospital private equity. The nation\u2019s \u201cnonprofit\u201d hospitals are sitting on more than\u00a0<a href=\"https:\/\/khn.org\/news\/article\/mission-and-money-clash-in-nonprofit-hospitals-venture-capital-ambitions\/\" target=\"_blank\" rel=\"noreferrer noopener\">$283 billion<\/a>\u00a0in financial assets they invest Wall Street-style to generate even higher returns. HCA Healthcare, the nation\u2019s largest private healthcare system, made\u00a0<a href=\"https:\/\/investor.hcahealthcare.com\/news\/news-details\/2022\/HCA-Healthcare-Reports-Fourth-Quarter-2021-Results-and-Provides-2022-Guidance\/default.aspx#:~:text=Net%20income%20attributable%20to%20HCA,operating%20activities%20totaled%20%242.443%20billion\" target=\"_blank\" rel=\"noreferrer noopener\">$7 billion<\/a>\u00a0in profits in 2021.\u00a0<\/p>\n<p>CMS has assisted hospitals by choosing not to enforce the rule robustly. It has issued financial penalties on\u00a0<a href=\"https:\/\/www.cms.gov\/hospital-price-transparency\/enforcement-actions\" target=\"_blank\" rel=\"noreferrer noopener\">only two hospitals<\/a>\u00a0out of the thousands nationwide that are noncompliant. Yet even this meager response indicates that enforcement works. The two fined hospitals quickly became compliant and posted exemplary price files.\u00a0<\/p>\n<aside class=\"ad-unit ad-unit--mr2_ab\">\n<\/aside>\n<p>At a conference earlier this month, CMS Administrator Chiquita Brooks-LaSure was non-transparent about future enforcement,\u00a0<a href=\"https:\/\/insidehealthpolicy.com\/daily-news\/brooks-lasure-keeps-plans-price-transparency-fines-under-wraps\" target=\"_blank\" rel=\"noreferrer noopener\">stating<\/a>: \u201cWe have a lot of priorities, and the things that we will do in terms of enforcement always are ongoing and not things that we share.\u201d\u00a0<\/p>\n<aside class=\"thehill-promo-link\">\n\t\t<a href=\"https:\/\/thehill.com\/opinion\/energy-environment\/3794342-flying-blind-the-problem-isnt-flight-cancellations-its-flying\/\" class=\"thehill-promo-link__link\" target=\"_blank\" rel=\"noopener\"><br \/>\n\t\tFlying blind: The problem isn\u2019t flight cancellations \u2014 It\u2019s flying!\t<\/a><br \/>\n\t\t<a href=\"https:\/\/thehill.com\/opinion\/white-house\/3792170-a-question-for-2023-why-cant-the-world-be-more-like-a-cruise-ship\/\" class=\"thehill-promo-link__link\" target=\"_blank\" rel=\"noopener\"><br \/>\n\t\tA question for 2023: Why can\u2019t the world be more like a cruise ship?\t<\/a><br \/>\n\t<\/aside>\n<p>This lack of resolve is out of step with the American public. According to a new\u00a0<a href=\"https:\/\/www.kff.org\/report-section\/kff-health-tracking-poll-december-2022-the-publics-health-care-priorities-for-the-new-congress-findings\/\" target=\"_blank\" rel=\"noreferrer noopener\">Kaiser Family Foundation poll<\/a>\u00a0released last week, 95 percent of Americans want policymakers to make healthcare price transparency a key priority \u2014 more than any other proposed healthcare reform.\u00a0<\/p>\n<p>The two-year anniversary of the hospital price transparency rule is an occasion for the Biden administration to stand up for American healthcare consumers and step up to properly enforce the rule. Doing so can generate a consumer revolution that ushers in a functional, competitive healthcare marketplace that stops hospital overcharging and reverses outrageous national health expenditures.<\/p>\n<aside class=\"ad-unit ad-unit--mr3_ab\">\n<\/aside>\n<p><em>Cynthia A. Fisher is founder and chair of\u00a0<\/em><a href=\"http:\/\/patientrightsadvocate.org\/\" target=\"_blank\" rel=\"noreferrer noopener\"><em>PatientRightsAdvocate.org<\/em><\/a><\/p>\n<\/div>\n\n<br \/><a href=\"https:\/\/news.google.com\/__i\/rss\/rd\/articles\/CBMigQFodHRwczovL3RoZWhpbGwuY29tL29waW5pb24vaGVhbHRoY2FyZS8zNzk0Mzc2LW1ha2luZy10aGUtaG9zcGl0YWwtcHJpY2UtdHJhbnNwYXJlbmN5LXJ1bGUtYS1yZWFsaXR5LW9uLWl0cy10d28teWVhci1hbm5pdmVyc2FyeS_SAYUBaHR0cHM6Ly90aGVoaWxsLmNvbS9vcGluaW9uL2hlYWx0aGNhcmUvMzc5NDM3Ni1tYWtpbmctdGhlLWhvc3BpdGFsLXByaWNlLXRyYW5zcGFyZW5jeS1ydWxlLWEtcmVhbGl0eS1vbi1pdHMtdHdvLXllYXItYW5uaXZlcnNhcnkvYW1wLw?oc=5\">Source link <\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>New Year\u2019s Day marks the second anniversary of a federal\u00a0hospital price transparency rule\u00a0that has the potential to substantially lower outrageous healthcare costs burdening patients, workers, businesses, and taxpayers. The Centers for Medicaid and Medicare Services recently\u00a0announced\u00a0the nation spent $4.3 trillion on healthcare in 2021, nearly 20 percent of GDP and\u00a0almost two times\u00a0the developed-world average. The &hellip;<\/p>\n","protected":false},"author":1,"featured_media":39043,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[161],"tags":[],"_links":{"self":[{"href":"http:\/\/www.brandon.ddtest.info\/multisite-test\/wp-json\/wp\/v2\/posts\/39042"}],"collection":[{"href":"http:\/\/www.brandon.ddtest.info\/multisite-test\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/www.brandon.ddtest.info\/multisite-test\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/www.brandon.ddtest.info\/multisite-test\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/www.brandon.ddtest.info\/multisite-test\/wp-json\/wp\/v2\/comments?post=39042"}],"version-history":[{"count":0,"href":"http:\/\/www.brandon.ddtest.info\/multisite-test\/wp-json\/wp\/v2\/posts\/39042\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"http:\/\/www.brandon.ddtest.info\/multisite-test\/wp-json\/wp\/v2\/media\/39043"}],"wp:attachment":[{"href":"http:\/\/www.brandon.ddtest.info\/multisite-test\/wp-json\/wp\/v2\/media?parent=39042"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/www.brandon.ddtest.info\/multisite-test\/wp-json\/wp\/v2\/categories?post=39042"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/www.brandon.ddtest.info\/multisite-test\/wp-json\/wp\/v2\/tags?post=39042"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}