Statement on the Final Rule on Hospital Pricing Transparency

By Blair Childs, Senior Vice President, Public Affairs

Premier strongly supports transparency in healthcare pricing and efforts to help consumers understand what share of the cost they will shoulder for their care. While well-intended, CMS’ policy to require hospitals to post standard charges, gross charges and payer-negotiated rates will do little, if anything, to provide patients with this information. Moreover, we are concerned that CMS lacks the statutory authority to implement this policy, which means that this issue will be tied up in the courts when more important and productive progress could be made.

We urge HHS to, instead, speed the movement to alternative payment models (APMs) and provider access to claims data. When providers are accountable for the cost and quality of care, the market will force transparent competition around price and outcomes. This is the goal the President’s Executive Order seeks to achieve.

Moreover, to succeed in APMs, providers need access to claims data. HHS needs to take steps to encourage Medicare Advantage plans to make this claims data available to providers in APMs.

By taking these steps, the administration will inspire competition around price and quality and thereby achieve its goal.