The Transparency in Coverage final rule released by the Department of Health and Human Services (HHS), the Department of Labor, and the Department of Treasury puts health care information in the hands of consumers and has the potential to impact all healthcare providers.
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The rule was a result of President Trump’s executive order on Improving Price and Quality Transparency in American Healthcare to Put Patients First.
Under the rule, hospitals must disclose standard charges, including negotiated rates with third-party payors.
Under a previous rule, hospitals are expected to start sharing their prices in January.
Under this rule, employer health plans and insurance companies will be required to post in-network and out-of-network rates they negotiate with providers. They will also need to share how much they are willing to pay out-of-network physicians.
Insurers will need to disclose cost-sharing estimates and will need to develop online price transparency tools.
While the impact is yet to be seen, the goal is to boost competition among hospitals and insurers to drive down healthcare costs. Patients will be able to see their costs prior to receiving treatment, and in theory, will be able to shop around.
Hospitals and physicians have voiced opposition, as they are worried about their administrative costs. Others have asked that quality metrics also be posted, in addition to costs.
Have you read the final rule? Let us know what your thoughts are by commenting below!
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