TUCSON, Ariz., Nov. 18, 2019 /PRNewswire/ -- Prices of medical care are too often unknown until the patient receives the bill after the fact, so the Association of American Physicians and Surgeons (AAPS) thanks the Trump Administration for rules issued last week to help shine some sunlight on the secret prices that hospitals and health plans try to keep hidden from patients.
"Access to honest and actual prices is fundamental to ensuring patient choice and ultimately reducing medical care costs," explains AAPS in comments submitted in support of the proposed rule that was finalized Friday (CMS-1717-F2) — to take effect in 2021 — requiring hospitals to disclose actual prices.
AAPS also plans to submit additional comments in support of the newly announced proposal (CMS-9915–P) that aims to ensure health plans unveil prices they have agreed to pay hospitals for care provided to enrollees. In fact, in 2018 AAPS previously encouraged the administration to implement such a policy, stating: "It should be incumbent upon insurers to make information about contracted rates readily available to their enrollees. How can enrollees make informed choices without knowing ahead of time, as much as practical, what their insurer will pay for a given procedure at a given facility?"
The Surgery Center of Oklahoma (SCO) is proof-in-concept that true price transparency, and excising third party control over payment, increases access to lower-cost, high-quality medical care. SCO's model is being successfully replicated at other facilities despite overregulation impeding physicians from opening and operating surgical facilities. Transparency not only pushes down prices, but increases overall patient and physician satisfaction, as shown in a 2018 study from Johns Hopkins University.
Unfortunately, the prediction by AAPS that "the health system swamp will be pulling out all the stops to kill President Trump's proposal," is already proving to be true: "Hospitals are already getting ready to sue," reports Robert King for FierceHealthcare.
As these solutions move forward, AAPS urges the President, "Do not weaken the proposals to benefit special interests at the expense of patients. Please continue addressing decades of federal policies that have compounded to contributed to the epidemic of price-opaqueness in medical care. Properly functioning markets ultimately do not require mandates; they make price information easily available or risk losing paying customers."
For additional steps to correct past policy failures, AAPS encourages President Trump and his administration to review the White Paper on Medical Financing and White Paper on Freedom for All vs. Medicare for All. AAPS maintains that the only way to decrease costs while improving quality and access is through free-market competition, honest price signals, and restoring control over their own money to the Americans who earned it.