Trump order pushes for disclosure of secret health care prices |
Politics Election

Trump order pushes for disclosure of secret health care prices

President Trump holds up an executive order he just signed on improving price and quality transparency in healthcare at the White House in Washington, Monday, June 24, 2019.

WASHINGTON — President Trump called for hospitals to disclose to patients up front how much they charge for tests, surgeries and other procedures, in an executive order he signed Monday.

The federal regulations Trump is calling for push forward a relatively simple idea: that patients should know how much hospitals charge for common procedures. Those prices are typically trade secrets between hospitals and the insurers they negotiate with.

The administration also wants to make medical providers and insurers give their patients estimates of out-of-pocket costs before they get care.

“We’re fundamentally changing the nature of the health care marketplace,” Trump said Monday at the White House. “Prices will come down by numbers you can’t even believe.”

Details of the executive order were described earlier by Secretary of Health and Human Services Alex Azar, whose department will draft the regulations. The changes are likely to face significant pushback from the health care industry.

“Every day, American patients are being taken advantage of by a system that hides critical information from them,” Azar said on a conference call with reporters.

The health insurance industry’s main trade group said the plan will backfire. “Publicly disclosing competitively negotiated, proprietary rates will reduce competition and push prices higher — not lower — for consumers, patients and taxpayers,” Matt Eyles, president and chief executive officer of America’s Health Insurance Plans, said in an emailed statement.

Eyles said the industry supports giving patients accurate information about their costs, but publishing negotiated rates would create “a floor — not a ceiling — for the prices that hospitals would be willing to accept.”

The Trump administration has advocated for bringing down health care costs by making prices more visible, boosting competition and reducing regulation. Trump has also called on Congress to pass legislation to stop surprise billing, while major pharmaceutical companies are revealing drug prices online in a bid to stave off pressure from the administration.

Many health care prices are veiled behind contracts between hospitals and insurers. Employers and patients have complained that such secrecy keeps prices high and makes it harder for employers and individuals to shop for services.

The administration took a step toward more transparency earlier this year by requiring hospitals to post their list prices, known as the chargemaster, online. That information, designated with arcane billing codes, is hard for consumers to decipher. Few people actually pay the list prices, which can be multiples higher than insurers’ contracted rates.

Prices paid by private insurers can be many times the amounts paid by Medicare, the government health insurance program for older Americans, research by health economists has found. Contracted rates can also vary wildly among health plans and providers, meaning that the same test or procedure could be vastly more expensive at different facilities in the same city.

Patients are often in the dark about those rates until they get a bill.

The new executive order goes significantly further than earlier proposals in attempting to make privately negotiated rates public. Though the details will be determined during a rulemaking process that allows industry and other stakeholders weigh in, Azar portrayed it as a watershed moment.

“What we’re announcing today will put American patients in control and address the fundamental drivers of high American health care costs in a way that no president has ever done before,” Azar said.

Hospital care cost Americans about $1.1 trillion in 2017, accounting for one-third of all U.S. medical spending. The Trump administration wants to make available “in an easy to read, patient-friendly format, prices that reflect what patients and insurers actually pay,” Azar said.

The order requires HHS to propose a way to make health care providers and insurers give patients an estimate of their out-of-pocket costs ahead of service. Azar shared a personal story of trying to get the price of a routine heart exam at a hospital, a struggle even for a senior health care official.

Other aspects of the order attempt to simplify quality reporting requirements, expand access to de-identified medical claims data and expand the use of health savings accounts.

TribLIVE commenting policy

You are solely responsible for your comments and by using you agree to our Terms of Service.

We moderate comments. Our goal is to provide substantive commentary for a general readership. By screening submissions, we provide a space where readers can share intelligent and informed commentary that enhances the quality of our news and information.

While most comments will be posted if they are on-topic and not abusive, moderating decisions are subjective. We will make them as carefully and consistently as we can. Because of the volume of reader comments, we cannot review individual moderation decisions with readers.

We value thoughtful comments representing a range of views that make their point quickly and politely. We make an effort to protect discussions from repeated comments either by the same reader or different readers

We follow the same standards for taste as the daily newspaper. A few things we won't tolerate: personal attacks, obscenity, vulgarity, profanity (including expletives and letters followed by dashes), commercial promotion, impersonations, incoherence, proselytizing and SHOUTING. Don't include URLs to Web sites.

We do not edit comments. They are either approved or deleted. We reserve the right to edit a comment that is quoted or excerpted in an article. In this case, we may fix spelling and punctuation.

We welcome strong opinions and criticism of our work, but we don't want comments to become bogged down with discussions of our policies and we will moderate accordingly.

We appreciate it when readers and people quoted in articles or blog posts point out errors of fact or emphasis and will investigate all assertions. But these suggestions should be sent via e-mail. To avoid distracting other readers, we won't publish comments that suggest a correction. Instead, corrections will be made in a blog post or in an article.