Posted on 01/02/2021 7:16:14 PM PST by SeekAndFind
Major hospital operators say they will comply with new rules to make public their prices for medical procedures starting Friday, exposing previously secret market rates in an industry that accounts for about 6% of the U.S. economy.
The roughly $1.2 trillion hospital sector will begin posting prices publicly in the New Year after losing a legal challenge to overturn new transparency rules that are a centerpiece of the Trump administration’s health-care policy.
Health and Human Services Secretary Alex Azar said earlier in December the hospital pricing data and other transparency rules put forward by the administration were fundamental to a competitive market.
Hospital pricing is negotiated confidentially between hospitals and the employer groups and insurance companies that pay for care, which has obscured market rates that have helped drive up the cost of health insurance premiums paid by employers and workers. Rising hospital prices accounted for about one-fifth of the nation’s health spending growth in the last half-century, federal data show.
The nation’s largest hospital chains, including publicly traded giants HCA Healthcare Inc., Universal Health Services Inc. and Community Health Systems Inc., and national nonprofit chains CommonSpirit Health and Ascension, said they planned to comply with new requirements to post pricing. Tenet Healthcare Corp. declined to comment.
“Ascension supports price transparency of our hospital services for the benefit of consumer choice and access to care for those we serve,” said Nick Ragone, a spokesman for the St. Louis-based chain.
As of Jan. 1, hospitals will be required to publish the prices negotiated privately with each payer for 300 common services for easy use by consumers, and make public the same information for all their procedures in a format that can be read and analyzed by computers.
(Excerpt) Read more at wsj.com ...
I like this paragraph from Zero Hedge better giving credit where credit is due:
President Trump’s health-care policy ambitions didn’t receive much attention from the mainstream media, but as we head into the new year, some of his market-based reforms are starting to become reality.
One of the most important is a directive requiring the nation’s biggest hospital chains to publish the rates they’ve agreed to charge various insurers. As WSJ explains, after a failed attempt at an appeal, the major hospital operators are saying they will comply with the new rules and make their prices public starting on Friday.
Suddenly, America’s hospital operators, a $1.2 trillion industry comprising some 6% of the country’s economy, will be subjected to more transparency than they’ve seen in decades. And the Trump Administration policy wonks he pushed the idea are hoping that good ol’ fashioned market dynamics will kick in, and help lower prices across the board.
Per WSJ, the nation’s largest hospital chains, including publicly traded giants HCA Healthcare, Universal Health Services and Community Health Systems, and national nonprofit chains CommonSpirit Health and Ascension, are planing to comply with new requirements to post pricing. Tenet Healthcare declined to comment.
Within a week, hospitals will disclose prices for 300 common procedures.
Does this mean the hospitals have to report all of the $3000+ they received for every hoax Covid case they reported?
Wow!
What a great act by President Trump!
just the pricing of medicine hacks me off
notwithstanding how cheap it is in India where they make it.
There can be a wide variety of prices for the same medicine depending on what coupon code you use...insurance versus Goodrx or Amazon Prime member Pharmacy savings card, etc.
I was looking at the prices in Rupees of a medicine and compared it to US prices. I thought maybe the exchange rate was messed up..I had to redo it just to be sure
Good luck getting the 70%-85% discount that Medicare/Medicaid gets. Best I have done for a “cash customer” is around 30% off....40% once in awhile depending on the Dr./lab.
Fabulous. Thank you, President Trump.
President Trump continues to throw wrenches into the gears of Global Reset. Hoo ah!
I got screwed over one time with a lab because their policy for people with no insurance was that you had to tell them ahead of time to get the discount
I didnt feel like dealing with it...but the price I had to pay was a lot higher than the insurance price.
Its a scammy racket.
The Uniparty looks out for globalists and multinationals.
Yep, way too much government price-fixing and involvement in paying for over 50% of all health care. Only way to fix health care pricing now would be to roll back to “cash only” payments and get the government 100% out of the “payer” side. The “cash-only” prices would be at a 60%-80% discount over current “retail” prices due to competition and lack of government price-fixing. Then slowly reintroduce traditional “group” health insurance (also at a 60%-80% discount over current premium rates).
Extremely unlikely to happen tho...USA will go “single-payer”/socialized long before they would go with my solution. After all health care is apparently a “right” nowadays...like housing, food, cell phones, and Internet access. I think access to work via transportation is a right...the govt. should buy me a Tesla under the “Green New Deal”!! ;-)
Long overdue.
I am in the health insurance biz. One lab charges 280 for bloodwork, another 450 same blood work. See it all the time.
Larger insurance carriers get better contracts.ie. lower prices.
If a consumer calls in they will never give out the price because most do not know what it is.
“You do realize hospital systems and MDs use DRGs to call/negotiate the BS you are spewing.”
Been in the business 35+ years. If that is the case why do doctors and hospitals drop out of networks with new pricing and stay with other networks? Why did 90% of local providers threaten to quit one of our local HMO’s and put a signed ad in the local newspaper due to lower pricing in the new contract? The HMO gave in.
I have numerous doctors insured. They tell me whats up.
I help clients with claims. I have seen the wide range of pricing for the same service from various insurance companies.
Bkmk
This has been the law in the Philippines for several years. You get a lab order and you ask what the cost is. If you don’t like the cost you can go outside of the hospital to private labs and save 50% or more there. A blood test, CBC, at the hospital is 500-1,000 Pesos, ($10-20), but 100-200 Pesos, ($2-4), at the private labs.
“The Federal government drives the darn costs/market, not the insurance companies.”
Anthem BC sent us a list of top 5 factors what drives prices. #1 was high utilization (obesity, smoking etc). I never said insurance companies drive the market but they do when it comes to contracts.
Premiums in my area are 30-40% higher than other parts of the country because we have the highest rates per capita of cancer, obesity and diabetes in the entire country. Another reason why we only have two insurance carriers to pick from in my county. Two.
The Affordable Care Act (Obamacare) banned the building of any additional physician-owned medical centers that would have been competition for the corporate duopoly of medical providers and health insurance. It was a corporatist bill through and through.
I appreciate the sentiment, but if I have a heart attack I’m probably going to skip shopping and price comparisons.
Seems to me the way it’s done now where the insurance company negotiates prices of procedures before hand is not an unreasonable way to control costs. Hospitals want the highest prices while insurance company want the lowest.
This was part of his American First Healthcare initiative.
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