Friday, the White House announced that President Trump’s initiative to increase transparency in Health Care costs was proceeding as planned and announced new proposed rules regarding health care price transparency.
Back in June, the President signed an Executive Order to make federal agencies demand from hospitals, clear statements of prices for “standard charges” beginning in 2021. These statements would then be made public so that patients could see what they were being charged – something standard in pretty much nearly every other industry or transaction. This new initiative was called “Improving Price and Quality Transparency in American Healthcare to Put Patients First.”
Friday’s announcement included new proposed rules on “transparency in coverage.” This would make insurance companies provide information about price and cost-sharing to the public so that they could compare prices and shop for their best options in health care in non-emergency situations.
If finalized, the proposed “Transparency in Coverage” rule would require health plans to:
Give consumers real-time, personalized access to cost-sharing information, including an estimate of their cost-sharing liability for all covered healthcare items and services
Disclose on a public website their negotiated rates for in-network providers and allowed amounts paid for out-of-network providers.
Encourage health insurance issuers to offer new or different plan designs that incentivize consumers to shop for services from lower-cost, higher-value providers by allowing issuers to take credit for "shared savings" payments in their medical loss ratio (MLR) calculations.
In the Minnesota House, I have fought or transparency in Health Care pricing. I was happy to see a bill I authored that requires doctors and clinics to post prices in their waiting room make it through the process to passage. Likewise, a bill I authored on price disclosure from Pharmacy Benefit Managers (PBM)s and lifted the gag order on pharmacists to disclose and offer the lower cash price of prescription drugs to insured patients. Both bills went into effect this past summer.
I will continue to champion my “Right to Shop” legislation, which would create an incentive for patients in non-emergency situations to shop around for the best value for procedures and services—precisely what the administration is aiming to do with these recent proposed rules changes.
The way forward on Health Care reform is price transparency and giving the public the tools to choose their own health care. As one of the first states to sign up for failed Obamacare, Minnesota now needs to lead the way away from it.