RIP Price Transparency, We Barely Knew You

April 29, 2021

 – Episode #

83

Who wanted to know how much their healthcare was going to cost or quality before they had a procedure? RIP, price transparency for healthcare?

Although the article says the Biden admin won’t pull the plug on price transparency, it essentially says, he’s pulling the plug on price transparency.

FTA
And while the Biden administration will continue price transparency initiatives, they probably won’t drive its healthcare agenda, experts said. Biden’s administration is likely more willing than its predecessor to pursue other legislative or regulatory changes to rein in healthcare costs, including price setting.

The main argument is that it’s too hard to track and doesn’t reveal anything that would change behavior. That is correct. It wasn’t designed to change the behavior of the patient yet, it was designed to change the system to accept an engaged patient who can respond to price.

We can’t measure each step in changing bureaucracy on it’s own, it has to be measured as progress towards the end game. An engaged patient the knows price and quality and can choose their provider accordingly. Just a thought.

#healthcare #healthIT #healthcarereform #cio #cmio

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Today in health. It, this story is rest in peace. Price transparency for healthcare. My name is bill Russell. I’m a former CIO for a 16 hospital system and creator of this week and health it a channel dedicated to keeping health it staff current and engaged. Today we have no show sponsor. So if you’re listening to this, you know, the power of podcasting, our show started a little over 90 days ago and we are approaching 10,000 downloads.

For every 90 days. And that number is only going to grow. If you want to get your message in front of a targeted healthcare audience and an email to partner at this week in health, it. Dot com. All right. Here’s today’s story.

Sometimes my crystal ball gets a little cloudy and I misread the tea leaves. So I have to backtrack on something. I said to make sure that you’re heading in the right direction. I believe that there were signals that this administration was going to continue with price, transparency, rules. But today I’m going to rescind any urgency. You may have felt to comply with price transparency.

If I were a healthcare CIO today, I would put this one on the back burner. I would reduce the team working on this and the funding that I’ve allocated to this to as little as possible. There is no carrot and it would appear that there will be no stick either. The status quo has been defended. And that is what we need in healthcare. More status quo.

Now to the article and I will apologize ahead of time my reporting this morning. It’s going to be loaded with cynicism. I read this article and it just makes me laugh every time I read it, because it was so overtly partisan towards hospitals and the status quo. , and make no mistake about it. This is a win for the status quo for healthcare.

They give a microphone to the lobbyists and the lobbyists again, just to make me laugh at some of the things they do. They, they essentially say, you know, it doesn’t, it’s not gonna make any difference. It’s too hard to track. , Hey, look at the payers. Don’t look at the providers. It really is kind of funny. I’m sorry, I’m going to go into it. So, and it starts right from that, from the headline, to be honest with you Biden, won’t pull the plug on price. Transparency experts say,

Which is a completely misleading headline. What it really should say is.

Price transparency, which was designed to help consumers is now going to be used as a tool to combat the health insurance industry. What you’ll see as we get into the article so let’s get into the article CMS plans to stop requiring hospitals, to report their median payer specific negotiated charges with Medicare advantage. Insurers is a win for hospitals and it is a win for hospitals and the status quo by the way.

Experts said. That it’s an easy way for the Biden administration to reduce administrative work for providers without giving up much in the way of price transparency. But it probably doesn’t say much about the Biden administration thoughts on price transparency, according to. Avalara health consultant time cornfield, which I don’t think is correct. And you’ll see that later in the article.

I wouldn’t read anything more into this, but it is a push for some in administrative simplicity, Lauren Adler associate director of the USC Brookings Schaffer initiative for health policy send an email. She goes on to say, and this is where it gets. I mean, again, just kind of silly price, transparency policies concerning Medicare advantage rate information. Wouldn’t do much to affect healthcare costs or spending because advantage plans pay nearly the same rates.

And she goes on to cite that. According to the 2018 study average is vantage price per discharge. Across all hospital stays was 10,667.

How hard is it to track this information and provide it. But this is one of the main reasons that’s given, oh, it’s going to take too many hours to track this and get this information out there. That’s one of the main reasons that they think we shouldn’t be doing this. And the second is it’s not going to make any difference. I’ll get to that in the, so what the price.

Transparency was central to the Trump administration’s health care agenda. As CMS included such requirements throughout its policies. And while there continued to be bipartisan support for greater transparency, which of course there is because we are used to transparency in every other aspect of our lives. We make no purchase decision without shopping. We make no purchase decision without knowing the quality of the product that we’re getting the quality of the doctor or the price that we’re going to paying as opposed to where else we can go. But it’s healthcare. So we don’t need to know the quality of our doctor nor do we need to know the price that we’re going to be.

And who are these experts? I, I I’d like to hear from these experts. Here we go. This was not a well thought out policy in the first place. It was really a waste of everybody’s time in the name of transparency, Federation of American hospitals, CEO, chip Khan, a lobbyist and the lobbyist organization. So our experts, our lobbyists, oh, it goes on there’s. There’s another expert hospitals strongly opposed the policy in part, because Trump’s CMS, didn’t do comprehensive analysis of how a market-based pricing approach would affect diagnosis related group payments, DRGs.

Or explain why it would be beneficial to the healthcare system. As a whole said, Joanna, Hyatt Kim. Vice-president of payment policy and analysis for the American hospital association. Another lobbyist organization, CMS was really conflating market-based prices with costs. You know, I might as well address this now.

Because their argument isn’t incorrect in that doing this transparency. I was not going to immediately impact the patient. And this wasn’t about the patient. This was about changing the system. When you do a transparency move, it’s not necessarily about changing behavior right away. It’s about changing the system. It is about shining a light into the healthcare system.

And the negotiated rates that are happening. And by doing that, it changes behavior behavior of the system and starts to change the system so that we can have. Activated consumers and activated patients who are making decisions based on the information that they’re being provided.

Let’s go down further in the article. Hospitals are hopeful that coming surprise billing regulations from CMS will allow the agency to pull back other price transparency requirements that don’t directly help consumers understand their financial obligations con. And Smith added. Okay. So they are going to use, I have no idea how they’re going to do this. This is another thing that just makes me giggle. Hospitals are hopeful that the surprise , billing regulations, the thing that is meant to help, to eliminate surprise bills for patients are going to somehow pull back even more price transparency. I want to know how we’re going to get a better view into surprise bills.

And also pull back more price transparency, but this is what they are hoping for. , because they represent hospitals and we have eliminated the work of hospitals and we have allowed the hospitals to operate in the dark with little light being shown into the process and price transparency.

Esther said it makes far more sense to focus price, transparency efforts, our commercial health lands, since there’s much greater variation in the rates provided in negotiations with them. And, uh, I’m sorry. The reason that makes me laugh is because remember the experts are the American hospital association. And what was the other lobbyist group? Federation of American hospitals.

, CEO. So the experts say don’t focus on the hospitals, focus on the payers, and this makes sense. The Biden administration is essentially heading in that direction. Anyway, they want Medicare advantage for all. They want a single payer system and you have to have a, fall guy in the fall guy for this will be the insurance carriers, and we’re going to cut them out completely and essentially forced them into life insurance and other things. And we are going to partner with the hospitals, which, you know, like trust and love and the federal government, which, you know, like trust and love, and we’re going to come together and we are going to take care of you. And by the way, we’re not going to have any transparency.

, behind that, which of course this takes care of price, transparency for Medicare advantage. With all these transparency efforts already out in the world, the case for a national all-payer claims database becomes even more clear. Cut Adler said a national health payer claims database could prove useful over time for identifying issues , in the healthcare system and crafting reforms.

Again, towards a single payer system. And while the Biden administration will continue price transparency initiatives, they probably won’t drive its healthcare agenda experts said Biden administration is likely more willing than his predecessors to pursue other legislative or regulatory changes to reign in healthcare costs, including price setting, which we did talk about earlier. We did expect more bundled payments and those kinds of things are returned to bundled payments.

Which is what the mode of operation was during the Obama administration. All right. I already gave you the, so what on this, this is a big win for the status quo, which means you don’t really have to do anything with regards to price transparency. And the, the reality is I would reduce my budget going towards this. I’d reduce the staffing going towards this. I’d reduced the number of meetings I have going towards this, because there’s going to be no carrot and stick.

And again, You don’t have to do anything with regard to price transparency. That is unless you claim to be consumer centric mission-based or operating in the best interest of your community, if you don’t happen to fall into any of these categories, forget about it. It’s an added expense to your budgets that you don’t have time for. Invest in HR optimization, digital tools. Tele-health why shine the light in the darkness. When you can let people grow up around trying to find the best healthcare for their family.

I was raised on good old Catholic guilt. How’d I do. That’s all for today. If you know someone that might benefit from our channel, please forward them a note. They can scribe on our website this week, health.com or wherever you listen to podcasts, apple, Google, overcast, Spotify, Stitcher. You get the picture. We are everywhere.

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