Our Take: New Regulations for Healthcare Pricing Transparency

Healthcare Pricing Transparency—Good for Employees and Employers | Corporate Synergies
“Our Take” is Corporate Synergies’ commentary on benefits/insurance topics in the news. This article discusses healthcare pricing transparency.

The Trump Administration has been working on two measures to make it easier for patients to estimate and understand the cost of healthcare.1

The Centers for Medicare and Medical Services (CMS) has published a final draft2 of the first rule that requires hospitals to post a comprehensive list of all standard charges, both for uninsured patients and those using group health insurance carriers.

Because this master list of charges may not be digestible for most audiences, a smaller, more consumer-friendly list will also be developed for the most common healthcare services. The second mandate will require an estimation tool be accessible to patients, providing a closer estimate of the final out-of-pocket cost before their medical service is rendered, as well as a list of their negotiated rates with in-network providers.

Our Take

In its final draft of the hospital pricing rule, CMS said, “By disclosing hospital standard charges, we believe the public (including patients, employers, clinicians, and other third parties) will have the information necessary to make more informed decisions about their care.”

We agree. While 2021 is more than a year away, it is shaping up to be consequential for healthcare pricing transparency, which can mean reduced stress for employees and new clarity for employee benefit managers.

Using tools that provide a clearer view of estimated out-of-pocket costs, will help patients plan accordingly. These resources will assist them in making better decisions about their healthcare before it’s rendered.

Healthcare pricing transparency tools will save employees valuable time.

Having an estimate of costs prior to treatment will likely eliminate the hours spent negotiating with an insurance carrier after a bill is received.

You can keep an eye on healthcare pricing transparency updates by visiting Corporate Synergies’ Compliance Resource Center, which is updated by our internal health and welfare benefits compliance experts on a routine basis.

1BenefitsPro, “Hospitals Must Post Real Prices Starting In 2021”
2Department of Health and Human Services (CMS), “Price Transparency Requirements for Hospitals to Make Standard Charges Public”

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Corporate Synergies is a national insurance and employee benefits brokerage and consultancy. Crafting creative plan designs, enhancing efficiencies and resolving compliance risk. Risk management strategies and insurance solutions for clients across a broad range of industries.


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