New Year, New Policy

By Anonymous -

What is the issue?
Beginning from the first of this year, hospitals are required to post their chargemaster online in an effort to improve price transparency and empower patients. This ruling stems from the 2019 inpatient and long-term care hospital prospective payment system in which the CMS included the requirement for hospital to update their public price lists annually.
CMS states, “ CMS encourages hospitals to undertake efforts to engage in consumer friendly communication of their charges to help patients understand what their potential financial liability might be for services they obtain at the hospital, and to enable patients to compare charges for similar services across hospitals.”

What does this mean for patients?
In theory this sounds like a step in the right direction. Visible prices could mean that consumers can compare prices across hospitals and choose the best option for them. However, according to business news website Modern Healthcare, there is concern that the chargemasters could cause confusion among consumers.
The prices listed by hospitals in their chargemasters are a starting point for negotiations between insurance companies and often don’t reflect what consumers are actually responsible for paying. So, while the mandate is well intentioned, it doesn’t provide practical help for consumers.

Takeaway
This mandate indicates that CMS intends to work on price transparency in an effort to make it easier for patients to compare prices across care options. This trend towards price transparency is the topic of discussion in Trinity MHA classes as students debate how these changes will impact the healthcare environment. Healthcare administrators need to be equipped to deal with these changes in order to continue to serve their communities.


Resources Referenced
  • https://www.cms.gov/newsroom/fact-sheets/fiscal-year-fy-2019-medicare-hospital-inpatient-prospective-payment-system-ipps-and-long-term-acute-0
  • https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/Downloads/FAQs-Req-Hospital-Public-List-Standard-Charges.pdf
  • https://www.modernhealthcare.com/article/20190110/TRANSFORMATION04/190119996


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