Guest Post Written by Jule Crider
As has been reported widely in the press, the President issued an Executive Order (EO) last week on price transparency that has implications for all healthcare providers.
I have pasted below excerpts from the American Hospital Association (AHA) news alert which highlights issues in the EO. These include letting patients know their out of pocket costs before care is provided, aligning quality metrics across federal health care programs, and providing access to health claims data for research. This last point is a particularly important one to the field of wound care.
It is not unfair to say that the Centers for Medicare and Medicaid Services (CMS) views Medicare Spending per Beneficiary (MSPB) as a crucial datapoint in assessing value of an intervention or therapy. If a treatment does not reduce MSPB, it is fair to ask whether it improves healthcare outcome. Unfortunately, acquiring and analyzing claims data to understand the economic value of therapeutic interventions requires considerable investment and has been a challenge in the field of wound care and hyperbaric medicine. Nevertheless, it may be easier for payers to make their claims data available for analysis than for hospitals to provide “easy to understand, consumer friendly information” on their prices.
President issues executive order on price transparency (a message from the AHA)
President Trump today issued an executive order aimed at improving health care price transparency and reducing costs.
Most notably, the order instructs the Department of Health and Human Services (HHS) to issue a proposed regulation within 60 days requiring hospitals to “publicly post standard charge information, including charges and information based on negotiated rates and for common or shoppable items and services, in an easy-to-understand, consumer-friendly, and machine-readable format.”
In addition, the executive order requires Health and Human Services (HHS) and the departments of the Treasury and Labor to issue within 90 days an advance notice of proposed rulemaking soliciting feedback on a proposal to require providers, insurers and self-insured group health plans to “provide or facilitate access to information about expected out-of-pocket costs for items and services to patients before they receive care.”
The order also instructs HHS and the departments of Veterans Affairs and Defense to create within 180 days a roadmap to align quality metrics across federal health care programs. In addition, it instructs federal agencies to expand access for researchers to de-identified health care claims data from federal programs.
Jule Crider is the Executive Director of the American Association for Wound Care Management