Health

Most Americans do not know the rule of transparency of CMS prices

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More than 90% of Americans are unaware of a CMS rule that allows patients to view and compare treatment costs on hospital websites so they can purchase care at lower prices, according to a recent survey of the Kaiser Family Foundation.

While only 9% of seniors have studied treatment rates online, they are more likely to experience the rule change than any other age group. Families with incomes above $ 90,000 are even more likely to know the need for hospitals to disclose price data. But these richer families have spent less time looking for prices than those with an income below $ 40,000.

“The low level of awareness of this federal requirement is consistent across age groups, income levels, and health status,” KFF said.

The Trump administration’s rule, which went into effect Jan. 1, requires hospitals to make price information accessible to patients so they can get care at lower prices from different providers. . The rule also requires that they make available a consumer-friendly display of at least 300 salable services, including 70 specified by CMS. Hospitals they do not need to publish a list of affordable services if they allow consumers to use a price estimator tool to calculate their shopping costs.

Prior to the implementation of the rule, hospitals issued aggregate fees, discounted for services, but that price is rarely what an insurer or patient paid.

More than 80% of respondents to the May survey said they had not studied the price of hospital treatments in the past six months.

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Experts say consumers are not likely to look for it, unless it is easy. Newly available pricing data is more likely to help third-party app developers, researchers and policy makers.

The Biden administration has promised a crackdown on hospitals breaching transparency obligations. More than 50 hospitals did not include specific negotiated rates for payers or did not comply with any part of the price transparency rule since March, according to Health Affairs. A dozen hospitals did not post any files or provide links to searchable databases that users could not download.

Nearly 92% of respondents to the survey with a chronic illness, who are more likely to need hospital care, do not know or are convinced hospitals will not share information on online pricing. Only 4% of black consumers surveyed were aware of the rule compared to their white (9%) and Hispanic (12%) counterparts. Black consumers are even more likely to suffer from chronic conditions than other groups, according to the Centers for Disease Control and Prevention.

Many adults who searched for prices online were no longer aware of the price transparency requirements, with 33% reporting that there was no mandate for hospitals to disclose prices compared to 20% among those who did. they didn’t look for prices.

CMS began checking hospital websites and reviewing complaints shortly after the rule entered. AAccording to an agency spokesman, the first round of warning letters to hospitals were sent in April. CMS can also fine hospitals up to $ 300 per day for violating disclosure requirements.

Some hospitals have struggled against price transparency regulations, arguing that consumers do not use price estimates to determine their care plans and the release of specific fees for payers could increase prices.


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