On Monday, June 24, the President signed an executive order designed to increase price transparency in healthcare. “To make fully informed decisions about their healthcare, patients must know the price and quality of a good or service in advance,” the order states. “With the predominant role that third-party payers and Government programs play in the American healthcare system, however, patients often lack both access to useful price and quality information and the incentives to find low-cost, high-quality care.”
The order further states that the federal government’s aim is to “to eliminate unnecessary barriers to price and quality transparency; to increase the availability of meaningful price and quality information for patients; to enhance patients’ control over their own healthcare resources, including through tax-preferred medical accounts; and to protect patients from surprise medical bills.”
The order directs the Department of Health and Human Services (HHS) to propose a regulation within 60 days to “require hospitals to publicly post standard charge information, including charges and information based on negotiated rates and for common or shoppable items and services, in an easy-to-understand, consumer-friendly, and machine-readable format using consensus-based data standards that will meaningfully inform patients’ decision making and allow patients to compare prices across hospitals.”
The order also directs HHS and the Department of Labor within 90 days, to solicit comments on a proposal to require healthcare providers, health insurance issuers, and self-insured group health plans to provide or facilitate access to information about expected out-of-pocket costs for items or services to patients before they receive care.
The order also covers and calls for agency action on other transparency and healthcare issues, including:
? Calling for a government report on impediments to price transparency;
? Increasing access to de-identified claims data from taxpayer-funded healthcare programs and group health plans;
? Expansion of high deductible health plans and HSAs;
? Treating direct primary care arrangements and healthcare sharing ministries as eligible medical expenses under section 213(d);
? Increasing the amount of funds that can carry over without penalty at the end of the year for flexible spending arrangements; and
? Addressing surprise medical bills.