In 2021, the Federal Centers for Medicare and Medicaid Services finalized the rules launched in 2019 by an executive order from then-President Donald Trump. According to rule,
“We believe that by disclosing standard hospital fees, the public (including patients, employers, clinicians and other third parties) have the information they need to make more informed decisions about care. We believe that the impact of these final policies will help increase market competition, ultimately reducing the costs of healthcare services and making them more affordable for all patients.”
But since then, there has been a lot of fight over whether hospitals are ignoring rules, whether regulators are implementing them properly, and whether consumers will use the information.
President Donald Trump is pushing for Fulsin on his part to ensure that efforts launched during his first term are in effect.
in New Presidential Order“I direct departments of the Treasury, Labor and Human Services to quickly implement and enforce Trump’s transparent medical price regulations.
group Patient Rights Advocate Since 2021, it has released a double report on regulations compliance, with North Carolina ranked 8th in the most recent report for compliance. However, in only 33% of the 49 reviewed hospitals that are adhered to, we average just above 21%. According to the PRA analysis, more than half (25 out of 49 hospitals) provide at least adequate price data, even if they are not fully compliant with the law.
Compliance with the rules has been removed nationwide and in North Carolina. Brad Briner, the new state treasurer; He spoke to the Carolina Public Press “The regulations that came out of CMS a few years ago were very intended. Unfortunately, the penalties attached to them were insufficient to force many people to participate. These hospitals are multi-billion dollar businesses and can pay small fines.”
His predecessor, Dale Forwell, carried out a mission to get the hospital to follow him. Key Reports The title, “North Carolina Hospital: Extreme Price Markup, Failure of Transparency in Shopping Hospital Services,” stated in 2023:
“There are too many hospitals in North Carolina that violate federal rules to hide prices from patients. Anti-competitive violations hinder patients’ ability to make informed decisions about healthcare. High prices, especially those charged prices.
Hospitals are the main reason the US spends far more
Healthcare is more than other developed countries, but with little accountability
There is low transparency to protect the financial health of patients. ”
When it came to clarify prices to the public, the report stated, “On average, only 51% of the 140 hospitals that disclosed commercial insurance prices on 16 common shopping services, the disclosure rate fell to 42% in cash prices on 16 shopping services. Only five hospitals disclosed commercial prices on all services.”
Regarding recommended behaviours, Forwell’s report said “patients have little reliance on crippling medical debt until the state acts to strengthen and enforce federal price transparency rules.”
In Transparency page Of the NC Health Care Association, formerly known as the NC Hospital Association, they list federal CMS regulations for price transparency reporting. We also list the state-level price transparency requirements. Law of 2013 And a NCDHHS Rules It implements that law. These require hospitals to submit annual reports “to accredited statewide data processors” and lay out the prices of general services. However, it is unlikely that the public will see hospital annual reports, not to mention using them to make instant healthcare decisions.
Therefore, despite some laws and actions over the years, it is unlikely that the public will have all the pricing information they need to shop for North Carolina health services. Trump’s Presidential Orderhe states within 90 days, his Treasury, Labor and Health Secretary should “issued a regulatory action update policy that guidance or suggests enforcement policies designed to ensure transparent reporting of complete, accurate and meaningful data.”
So, while this price transparency command may have some teeth, Folwell reports that states can add their own compliance requests.
My idea is that creating true price transparency is a big part of the cost-saving puzzle, but in itself does not solve the problem. Markets can “bend the cost curve” with competition and consumer choice, but creating an effective market requires more than just transparent pricing information.
The candy prices in the movie are very clear and conveniently displayed on a large board above the snack counter, but due to the theatre’s monopoly over snack options, these prices are three times the prices found at the gas station across the street. Therefore, we need to work on healthcare to reduce monopoly and increase competition (by expanding the fraud and expanding practice authority of senior nurses).
But even if you know the prices and don’t have a monopoly, if healthcare consumers aren’t encouraged to care about so much to save here and there, that doesn’t matter. And this is exactly how it goes in the US indirect payment system where third parties such as insurance companies and CMS will pay the bill. After paying premiums and co-payments, the hospital and my third-party payers may not be encouraged to be too concerned about the final price that will work out (possibly after bumping into each other for months). You need to find a side-way for third-party payers and care about the final price for the consumer.
So price transparency is certainly a good start, but by itself, lowering prices is not enough if providers aren’t competing enough and consumers aren’t incentivizing to shop.
