Starting January 1st, 2019, U.S. hospitals are required to post the price lists for their standard procedures online, allowing patients to have convenient access to the information they need to make informed decisions about their health care.
This new law, known as the Inpatient Prospective Payment System rule, was announced in April of 2018 and is part of a Medicare program aimed at greater transparency and user-friendliness in healthcare. It requires pricing information to be listed online in a format that can be loaded by computers, and it must also be updated at least once per year. The rule also applies to rehabilitation facilities, psychiatric hospitals, and critical access hospitals.
“We are just beginning on price transparency,” said Seema Verma, the head of the Centers for Medicare and Medicaid Services. “We know that hospitals have this information and we’re asking them to post what they have online.”
Verma believes the new rule fits well with the Trump administration’s push to help Americans get more information and make better decisions about their care.
Before the rule went into effect, hospitals were already required to make their pricing information available to the public, but they weren’t required to list it online, which often meant patients had a harder time accessing it. Now, however, anyone with internet access will be able to get the pricing information they desire with a few simple clicks.
Those who want to know how much of those costs their insurance will cover, of course, will still have to contact their insurance companies for the details. Tom Nickels, executive vice president for government affairs and public policy at the American Hospital Association, stresses that patients should not confuse the online prices with out-of-pocket prices.
“We do not want patients to forgo needed care,” said Nickels, “especially if the quoted price is for the total cost of the service and not what the patient will be expected to pay out-of-pocket.”
This new rule has the potential to help a lot of people, particularly those going through difficult health issues that require several appointments and procedures, including those with cancer, lifelong diseases like Alzheimer’s and diabetes, and more.
There are still more parts of this program in the works, including a new system starting in 2021 that will adjust how Medicare pays hospitals based on how well they update and maintain patient records online. There are also plans in the works to require pharmaceutical companies to post prices online, which experts believe would prompt drugmakers to offer lower competitive pricing rather than continuously raising drug prices.
Elizabeth Nelson is a wordsmith, an alumna of Aquinas College in Grand Rapids, a four-leaf-clover finder, and a grammar connoisseur. She has lived in west Michigan since age four but loves to travel to new (and old) places. In her free time, she. . . wait, what’s free time?