HHS proposes Medicare payment rules to encourage hospitals to be clearer about prices
The Washington Post
April 24, 2018
The Trump administration is proposing to rewrite rules on federal payments to hospitals treating older Americans on Medicare, making it easier for patients to see the prices of procedures and care.
As part of annual updates to Medicare payment rules, federal health officials also want to add $1.5 billion for the coming year to the funds for “disproportionate share” payments that help buffer hospitals from the expense of treating patients who cannot pay their bills. The increase is a sign that the government expects an influx in uninsured patients — something administration officials seldom discuss amid their moves to weaken the Affordable Care Act.
In addition, the revisions seek to motivate hospitals to improve electronic medical records, while eliminating certain measures of the quality of care that the government now requires them to report.
In a recent conference call with reporters, the administrator of the Centers for Medicare and Medicaid Services portrayed the payment changes her agency is recommending as part of a broad policy to “put patients first.” Seema Verma said the goal is to move away from a system that reimburses hospitals for the number of services they provide to one that rewards them for the value of their care.
The nearly 1,900-page proposed rule calls on hospitals to publish their standard charges online in a machine-readable form that will help insurers and other organizations analyze them. Verma said that would improve the transparency of hospital prices, empowering patients to choose where to go for treatment.
One health policy expert said that posting prices, while useful, is not as significant as insurance companies helping patients understand what portion of a hospital’s charges they would need to pay themselves.
Another aspect of the proposal would revamp the federal program that encourages hospitals to improve electronic health records, requiring them to share the data in a form that patients can take to their doctors or other health-care facilities.