New federal rule means hospital prices go public in 2019
A new rule going into effect January 1, 2019, will require hospitals to post a list of their standard prices online and make electronic medical records more readily available to patients.
The new rule, called the Inpatient Prospective Payment System rule, is part of a Medicare program aimed at pricing transparency in the healthcare system.
In March, the head of the Centers for Medicare and Medicaid Services, Seema Verma said the new requirement for online prices reflects the Trump administration’s ongoing efforts to encourage patients to become better-educated decision makers in their own care.
“We are just beginning on price transparency,” said Verma. “We know that hospitals have this information and we’re asking them to post what they have online.”
Hospitals are already required to disclose prices publicly, but this change will put that information online in a machine-readable format that can be easily processed by computers.
It may still prove to be confusing to consumers since standard rates are like list prices and don’t reflect what insurers and government programs pay.
Patients concerned about their potential out-of-pocket costs from a hospitalization would still be advised to consult with their insurance company.
Most insurance plans have an annual limit on how much patients must pay in copays and deductibles, although traditional Medicare does not.
In the case of online records, many health care providers already make computerized records available to patients, but starting in 2021 Medicare would base part of a hospital’s payments on how good a job they do at this task.
The Associated Press and FOX 13 News Tampa contributed to this report.