Trump Seeks Health Care Price Transparency From Insurers And Hospitals : Shots - Health News Two regulations announced Friday take aim at health care prices. One, to affect patients by 2021, addresses hospital rates. The second, a proposal, would require more upfront clarity from insurers.
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Trump Wants Insurers and Hospitals To Show Real Prices To Patients

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Trump Wants Insurers and Hospitals To Show Real Prices To Patients

Trump Wants Insurers and Hospitals To Show Real Prices To Patients

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AILSA CHANG, HOST:

Health care reform is what President Trump wanted to focus on today. The administration released regulations to increase price transparency for patients. And he spoke about them at the White House.

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PRESIDENT DONALD TRUMP: Our goal was to give patients the knowledge they need about the real price of health care services. They'll be able to check them, compare them, go to different locations so they can shop for the highest quality care at the lowest cost.

CHANG: All right, here to explain what these rules would do is NPR health policy reporter Selena Simmons-Duffin.

Hey, Selena.

SELENA SIMMONS-DUFFIN, BYLINE: Hi.

CHANG: So two regulations getting rolled out here. Give us the basics on what these rules are.

SIMMONS-DUFFIN: So the first one targets hospitals. Right now there is technically a way to get a list of charges from hospitals. It's called a chargemaster. But it's really, really hard to use. You just basically drown in information, and it doesn't really tell you that much about the real cost of things. So what this rule would do would require hospitals to make an easy-to-use, easy-to-access, searchable tool that shows the real charges for services - in-network charges, out-of-network, even cash prices. And that would go into effect in January of 2021.

CHANG: OK.

SIMMONS-DUFFIN: So the second rule affects insurers. Do you know, like, explanations of benefits that you get in the mail?

CHANG: Yes. Yes, yes, yes.

SIMMONS-DUFFIN: OK, so the idea is that you would get that up front before you go get a service. You would get something that tells you what it costs, whatever you're going to get...

CHANG: Yeah. Wouldn't that be nice?

SIMMONS-DUFFIN: ..What it costs, what the plan would pay and what you would owe at the end of it. And that's a proposed rule, so this kicks off a 60-day comment period. We don't know when it would go into effect. And the administration is saying that these two things put together is revolutionary and could transform health care.

CHANG: Revolutionary. Do you agree with that? I mean, how transformative would this be?

SIMMONS-DUFFIN: Well, it kind of depends. First, we don't really know what these tools are going to look like, how easy they will actually be to use. Second, what do you do with the information? Like, is there another hospital in your town that is offering a better price?

CHANG: Do you even have a choice?

SIMMONS-DUFFIN: Right. Exactly. If there is, then great; this information is useful. But it's not necessarily going to be useful for everyone. Of course, there are emergencies when you can't - you really can't shop around.

CHANG: Right. You don't have the time.

SIMMONS-DUFFIN: Right. So another promise of these rules is that it will lower health care costs. And that is a lot less clear. The argument from the administration is that once patients can shop around for better prices, hospitals will respond by lowering their prices to attract savvy consumers. But it's not - we just don't know if that's exactly how it's going to shake out when it hits the market.

CHANG: What I'm thinking is the hospitals and insurance companies, these are these two very powerful industries. Are they likely going to block these rules from going into effect?

SIMMONS-DUFFIN: They're definitely going to try. On a call with reporters this morning, administration officials basically said, bring it. They're ready to fight for these rules in court. They think they're on solid legal footing, that they have the authority to make these rules and enforce them. But several rules on health care that the administration has tried to put out have been tied up. Final rules never materialized. Things were withdrawn. One cautionary tale here is TV prices in ads. Do you remember drug companies were going have to put the list prices on the...

CHANG: Yeah.

SIMMONS-DUFFIN: Yeah, so a judge blocked that and said that Health and Human Services did not have the authority to make drug-makers comply. We're going to have to wait and see what happens here.

CHANG: All right, that's NPR health policy reporter Selena Simmons-Duffin talking about two new regulations the administration hopes to roll out.

Thanks, Selena.

SIMMONS-DUFFIN: Thank you.

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