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Does your organization have a strategic plan to address CMS FY19 IPPS proposed rule that requires hospitals “to make public their standard charges via the Internet?”

Written By: Fred Stodolak, Executive Vice President, Mark Spehar, Senior Vice President, Financial Services, Henry Gutierrez, Vice President, Financial Services

There is an increasing debate surrounding CMS FY2019 IPPS proposed rule, published April 24, that would require hospitals “to make public a list of their standard charges via the internet.” Discussions around this topic have pointed out a number of valid arguments:

  • Standard prices in the chargemaster published alone can be confusing to patients due to the different levels of patient acuity, inpatient or outpatient and in-network or out-of-network status.
  • Though providers already comply with the ACA requirements, consumers are simply not utilizing the processes in place to ascertain their cost information.
  • It would simply be better for the information to come from health plans, leaving hospitals to only focus on the uninsured and out-of-network patient costs.

However, regardless of the swirling debate, this proposed rule may be the next logical step in the CMS drive toward establishing pricing transparency. Whether the rule passes in 2019 or the issue is pushed off to 2020 or beyond, we recommend that forward-thinking healthcare organizations create a plan around their pricing practices to ensure their response is strategic rather than reactionary.

Healthcare pricing transparency is an issue that healthcare organizations need to be thinking about. We’ve put together several simple steps hospitals and health systems can take to proactively move toward greater pricing transparency. Read the full report.