It is difficult for regular people to know the cost of a healthcare service or treatment ahead of time, which is what gave rise to the No Surprises Act, and transparency rules for hospitals and health plans. These policies are designed to make healthcare prices public or to hold patients harmless from exorbitant prices. They were developed by the prior administration and last year’s Congress, but President Biden is supporting these policies. In fact, CMS has sent multiple warning letters to hospitals that fail to make their prices public and will penalize them (financially) if they don’t comply. But it turns out that putting a price to a healthcare service is complicated. Simplifying a health care procedure into one price is tough when procedures are tailored to meet the needs of an individual patient, and when multiple insurers have negotiated with a hospital / doctors based on several different variables (e.g., availability of competitors, geographic region, quality issues). And in the middle of a pandemic, there is not a lot of bandwidth to focus on a new and game-changing operational shift that will suddenly make the muddy healthcare price landscape clear. The trickiest part about this is making the enormous vats of information useful … and even The New York Times reports that, at the moment, you need a computer programmer to figure out what healthcare services cost. And even the Cambridge Dictionary uses that as an example of “clear as mud.”
August 27, 2021 | 2 min read
August 27, 2021
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