Much has been said about cost transparency in healthcare, and this week, the administration got slightly more specific, issuing an Executive Order calling for some regulations and reports:

The Federal Government aims to eliminate unnecessary barriers to price and quality transparency; to increase the availability of meaningful price and quality information for patients; to enhance patients’ control over their own healthcare resources, including through tax-preferred medical accounts; and to protect patients from surprise medical bills.

The order directs agencies to issue proposed regulations, first on price transparency for hospital prices (NB: while garnering much attention, hospital costs account for just 1/3 of the total healthcare spend), and then more broadly out-of-pocket expenses for beneficiaries of employer-sponsored and other health plans. Next, HHS, the AG and the FTC are supposed to issue a report

describing the manners in which the Federal Government or the private sector are impeding healthcare price and quality transparency for patients, and providing recommendations for eliminating these impediments in a way that promotes competition.  The report should describe why, under current conditions, lower-cost providers generally avoid healthcare advertising.

Next up is rationalizing health quality emasures across federal agencies, and then working on identifying claims data that should be made more widely avialble and then de-identifying them and releasing them.

The order then moves on to direct expansion of HDHP/HSA combos “that cover low-cost preventive care, before the deductible, for medical care that helps maintain health status for individuals with chronic conditions.”

Next up is a super-vague provision directing regulatory development ot make “expenses related to certain types of arrangements” deductible medical expenses. Examples given include direct primary care and health ministries but, again, as written, the provision is extremely vague.

Wrapping it up, there’s a nod to rolling over FSA balances and to getting a report from HHS on surprise billing.

There’s a lot in there; some is pretty vague, and some is more specific. In any event, there is likely to be significant pushback from the regulated community (even those who from time to time seem to embrace change) once these rules start making their way through the sausage factory.

For an Administration that has promised a terrific healthcare plan time and again, this smattering of somewhat positive-sounding calls for action is sort of anticlimactic, but it is not unexpected, given the state of divided government.

Setting aside the question of releasing proprietary or confidential information for just a moment, the challenge for the industry is to consider which of the price transparency initiatives it may wish to tackle even before the regs come down the pike, or what sorts of alternatives to consider, in order to improve customer relations.

David Harlow
The Harlow Group LLC
Health Care Law and Consulting

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