by Robert King | Aug 26, 2019
While the Trump administration wants hospitals to begin posting “shoppable” prices online starting next year, some hospitals are scrambling to figure out how they’ll be able to meet such a requirement.
Some officials have complained that they do not have contracts automated in order to post such rates. Others say it will create major problems as they release payer rates with little context for the patients who are supposed to benefit from such transparency.
The Centers for Medicare & Medicaid Services (CMS) proposed the requirement hospitals post payer-negotiated rates for certain shoppable services starting on Jan. 1, 2020, as part of its outpatient payment rule earlier this month. The proposed rule is open for comment now, and CMS must release a final rule by November.
The rates must be available in a consumer-friendly format online and be searchable.
CMS projected in the proposed rule that the cost for implementing the new transparency requirement would be around $1,000 per hospital. However, some hospitals are balking at that figure, because their contract rates with insurers are not automated or online.
“Yesterday, I spoke with a 700-bed hospital in the Midwest that has over 600 contracts,” said Rick Louie, managing director of data analytics consulting firm Hospital Pricing Specialists. “They said it’s virtually impossible to display every contract rate in a searchable form, regardless of infinite time and money. If a 700-bed hospital has these issues, the cash-constrained rural hospitals don’t have a chance.”