If no items at the grocery store had price labels, would you load up your cart and roll it to the check-out line anyway? No? Then why would you do that with your healthcare?
Price Transparency refers to the disclosure of pricing information for healthcare services which enables patients to choose the most affordable options for care.
Laws are Under Evaluation
On January 1st, 2021, the Affordable Care Act required that hospitals publish a list of standard charges for all given services.* If all goes to plan, then by January 1st, 2023, insurers will be required to make rates and cost estimates for common services available to members—just like MotivHealth already does! In the meanwhile, by January 1st, 2022, insurers will be required to publish:
- Negotiated rates for all covered items and services
- Negotiated rates and historical net prices for all covered prescription drugs
- Historical payments and billed charges from out-of-network providers
What are the Benefits?
In addition to abolishing shocking medical bills, The Price Transparency Initiative aims to lower healthcare costs overall. The expectation is that if consumers are able to shop for the lowest healthcare prices, insurance companies and hospitals will be forced to lower their rates in order to compete with one another.
*These transparency requirements were passed in the original Affordable Care Act, but CMS, under Trump, began issuing rules about what needed to be done to meet the ACA pricing transparency rules. Additionally, a second law was passed that requires insurance companies to publish cost estimates starting January 1st, 2022.
Click the links below for more information on Price Transparency:
“Price Transparency: Empower Yourself”
“CMS Completes Historic Price Transparency Initiative”
Centers for Medicare and Medicaid Services
“Price Transparency and Variation in U.S. Health Services”