On Jan. 1, 2019, hospitals will need to comply with new U.S. Health and Human Services rules that call for greater transparency in pricing and billing.
“This payment proposal takes important steps toward a Medicare system that puts patients in charge of their care,” said HHS Secretary Alex Azar. The new rules allow patients “to receive the quality and price information needed to drive competition and increase value.”
According to a news release from the HHS’s Centers for Medicare & Medicaid Services, the rule also solicits feedback on further actions, “which will be necessary to disrupt our existing system and deliver real value for healthcare consumers,” Azar said. “We are going to move toward a system that provides better care for Americans at a lower cost.”
According to a March 5 speech Azar gave to the Federation of American Hospitals, “part of the problem (with healthcare in America) happens to be the equation that we’ve used for healthcare in this country for decades now: paying for procedures and sickness. For over a decade, we have been on a journey to replace that equation with a new one — paying for outcomes and wellness — but that transition needs to accelerate dramatically.”
The policy changes, according to the HHS’s website, include:
- Requiring hospitals to post their standard list of prices on the Internet and in a machine-readable format, rather than just being required to make them available in some form
- Focusing the Electronic Health Record Incentive Program on promoting interoperability, to allow patients to control their records and access them in a usable format
HHS also issued a request for comment on new ways to:
- Stop “surprise billing” by insurance and medical care providers.
- Provide patients better information up front about the out-of-pocket costs they will face.
- Encourage further transparency from providers, including providing tools for comparing prices and making public which institutions are out of compliance with transparency measures.
- Push providers reimbursed by Medicare to take more steps in making their electronic health records interoperable.