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This could be a game changer in the hospital industry. There is a new rule going into effect on January 1, 2019. It will require hospitals to post a list of their standard prices online. They will also have to make electronic medical records more readily available to their patients.
This new rule is called the Inpatient Prospective Payment System rule. It is part of a Medicare program aimed at pricing transparency in the healthcare system.
The head of the Centers for Medicare and Medicaid Services, Seems Verma, said in March that the new requirement for online prices reflects the Trump administration’s ongoing efforts to encourage patients to become better-educated decision makers in their own care.
“We are just beginning on price transparency,” said Verma. “We know that hospitals have this information and we’re asking them to post what they have online.”
Previously, hospitals have been required to disclose prices publicly. But this change will now make sure that the required information is available online in a machine-readable format. It has to be easily processed by computers.
This may still be fairly confusing to consumers because standard rates are like list prices. They don’t reflect what insurers and government programs pay. So patients who are concerned about their potential out-of-pocket costs from a hospitalization are still advised to consult with their insurance company.
It is typical for most insurance plans to have an annual limit on how much patients must pay in copays and deductibles, although traditional Medicare does not.
Regarding online records, many health care providers already make computerized records available to patients, but starting in 2021 Medicare would base part of a hospital’s payments on how good a job they do with this effort.
Do you think this is going to make a difference for consumers? We look forward to seeing your comments at the end of this article.
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