Hospital Price Transparency Initiatives: What You Need to Know

Last week the American Hospital Association released a report (link below) on the variety of approaches being taken by hospitals and health plans regarding price transparency. The report also includes a high-level analysis of related government initiatives at the state and federal levels.

Price transparency across the nation is a patchwork of activity. Currently, 35 states are requiring hospitals to release data on some of their charges. Seven states are saying the release of this data is only voluntary. It’s a fluid situation, so having a strategy in place to address these requirements is must for hospital executives involved in these areas.

At the federal level, CMS has released hospital-specific average charges and Medicare reimbursement rates (link below) for 100 of the most common inpatient procedures and 30 of the most common outpatient procedures since June 2013. The data shows the amounts that providers are billing for services, procedures and medical items.

At the local level, hospitals are implementing a variety of efforts aimed at achieving price transparency, but the tasks are complicated by contractual obligations that restrict hospitals from releasing rates negotiated with payers. As a result, these activities require expertly managed collaboration among all of the various stakeholder groups.

To learn more, visit the links below to access the AHA report and CMS charge data.

AHA Report: “Price Transparency Efforts Accelerate”
http://www.ahacommunityconnections.org/content/14tranparency-trendwatch.pdf

Charge Data Released by CMS:
http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Medicare-Provider-Charge-Data/