Trump Makes Bid For 'More Transparency' In Hospital Charges To Insurers : Shots - Health News A little-noticed Trump administration proposal would require hospitals, doctors and insurers to post the true, negotiated price for a medical procedure or service, as opposed to the "list" price.
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U.S. Hospitals And Insurers Might Be Forced To Reveal The True Prices They Negotiate

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U.S. Hospitals And Insurers Might Be Forced To Reveal The True Prices They Negotiate

U.S. Hospitals And Insurers Might Be Forced To Reveal The True Prices They Negotiate

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MARY LOUISE KELLY, HOST:

The Trump administration is considering requiring hospitals to post publicly the prices they charge to insurance companies for in-network services. This would be a big deal. That is because these prices are negotiated in secret and kept that way by hospitals and insurers. It's one of several efforts by the administration to shed light on the murky business of health care pricing. Joining us now is NPR's Alison Kodjak to talk all about this idea and how it might fit into the administration's strategy on health care costs. Hi, Alison.

ALISON KODJAK, BYLINE: Hi, Mary Louise.

KELLY: OK, so what is this proposal? What's the goal here?

KODJAK: So it's not a full-blown proposal. But HHS is arguing that the health care system, the hospital pricing system is way too complex and opaque. Consumers don't know what they're buying and what they're paying for it. You know, we've been doing this whole series of stories about patient bills...

KELLY: Yeah.

KODJAK: ...Where they're just shocked by what they or their insurance company are charged for services. So HHS suggests that if people know those prices, they can shop around for care on price. But the point's debatable whether they'll actually do that.

KELLY: Debatable why - I mean, why wouldn't you shop around for a better price?

KODJAK: Well, the theory, it could work. But it doesn't always work at the level of the patient. People running to an emergency room aren't going to shop for price. People who are scheduling surgery, they often go to where their doctor sends them or to that hospital with the best reputation, which might be the most expensive one. I talked to Zack Cooper, who's an economist at Yale who's looked at this stuff pretty closely. And here's what he says.

ZACK COOPER: So the first thing we know is that most consumers don't look at the price of health care services before they access care. I think we need to understand that most folks are not going to often go Googling hospital prices and then make big changes to where they access care.

KODJAK: But what Cooper does say is that the administration's probably pointing in the right direction here because he just published a study, and it shows that hospital prices are rising much faster than, say, doctors' fees.

KELLY: Right, which prompts me to ask, if it's debatable whether you or I or any of us might make different decisions based on these price points, is another piece of this that shaming health care providers into not charging those crazy prices you've been reporting on might be facilitated if there is more public transparency here?

KODJAK: Yeah, and there's some research that shows that companies are responsive to consumer anger, like naming and shaming. There was a recent survey by the Kaiser Family Foundation that showed that companies worry about what consumers think. But economists still say that if these prices are revealed, lower-priced hospitals might also increase their prices when they see the better deals that their competitors are getting.

KELLY: Has there been much public reaction so far?

KODJAK: Well, it's been pretty mixed. There are public comments on the government's website where they posted this. And people love it. The people out there are saying, yes, we need this. We want to see this. So even if research shows they're not shopping, they seem to want it to be out there - the American Hospital Association, not so happy with the idea. I talked to their head of government relations, Tom Nickels. And this is what he said this morning.

TOM NICKELS: That isn't really what consumers need or want. What consumers need and want is what are their out-of-pocket costs. The negotiated rate between a hospital and an insurer or a physician and an insurer is not particularly relevant to the consumer.

KODJAK: So they're saying the consumers aren't paying these prices, so why would we post them? And that's similar to the reaction that drug companies have had when HHS has made similar proposals on pricing there.

KELLY: Although, is it fair to see this as part of a bigger effort to deal with health care prices, drug prices, all of it writ large?

KODJAK: Yes, it is. And as I mentioned, the administration put out these proposals on drug prices. They also really push for more transparency and less complexity in the pricing market so that people can see what their health care providers and their drug companies are charging their insurance companies because that eventually gets into premiums. So the administration overall is trying to just make the market more transparent.

KELLY: NPR's Alison Kodjak, thank you.

KODJAK: Thanks Mary Louise.

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