June 26, 2019
New Executive Order on Health Care Price and Transparency
Earlier this week, President Donald Trump signed an executive order aimed at improving price and quality transparency in health care in order to arm patients with information they need when accessing health care.
According to the order, the Department of Health and Human Services (HHS), Department of Labor (DoL) and Treasury Department will work together to require insurance companies to provide patients with information on cost of care, including out of pocket costs, before patients seek services rather than after they obtain care (as is the case today). HHS will also require hospitals to publish charges and disclose information about their negotiated rates in a form that is understandable and useable by patients.
HHS, Department of Defense (DOD) and the Department of Veterans Affairs (VA) will develop a comprehensive health care quality roadmap so there is consistent, quality metrics across all programs. The departments will issue the roadmap within 180 days.
In addition, the order will allow access to health care data and ensure that the relevant government departments (HHS, (DOD), VA and Office of Personnel Management) are disclosing de-identified data that protects privacy but will also help transform the market place through the development of tools and analytics aimed at improving quality and decreasing price. This process will occur within 180 days.
Lastly, the Department of Treasury will allow more Health Savings Account (HSA) options, including expanding the range of services that can be considered preventive care and can be counted towards the deductible. Changes will be forthcoming within 120-180 days.
HHS, DoL and Treasury will issue an advanced notice of proposed rulemaking within 90 days. HHS will also issue a proposed regulation within 60 days.
ASA supports efforts to ensure health care transparency; yet, has some concerns as the order will require providers to disclose information to patients in a one-page list of prices— a challenging burden for facilities. However, this will not negate the issue of surprise medical bills. As providers must disclose prices up front, they would need access to each individual’s insurance plan, creating increased health care costs. Furthermore, patients will have the additional responsibility of understanding their own insurance policies as well as the possible variations in price due to complications during a procedure or the variations in time it takes to complete a procedure. This is especially true for anesthesia and the time-based nature of how services are billed, as well as the many aspects of care that are unpredictable. ASA will continue to monitor this Executive Order developments.