Editor's Note Average prices for healthcare services trended upward from 2018 to 2022 despite fluctuations in utilization of service, according to the annual Health Care Cost and Utilization Report (HCCUR) from the Health Care Cost Institute (HCCI). In the same timeframe, per-person spending increased nearly 19%. "Prices, in particular, pose a…
Editor's Note The US House of Representatives may vote this week on The Lower Costs, More Transparency Act. Introduced September 8, the proposed act aims to boost healthcare pricing transparency so consumers can make more informed decisions. Key elements include: Hospitals, payers, ambulatory surgery centers (ASCs), and other facilities would…
Takeaways • Healthcare consumers are not aware that they can ask how much something costs. • There is disconnect between the law and common knowledge, and patients generally are confused about what they receive as good faith estimates. • In addition to incorrect CPT codes and OON allowable charges, the…
Editor's Note On July 13, the Centers for Medicare & Medicaid Services (CMS) issued a proposal that would increase Medicare hospital outpatient prospective payment system rates by a net 2.8% in 2024 compared to 2023, including a “proposed 3% market basket update, offset by a 0.2% cut for productivity,” the…
Editor's Note This study from Harvard Medical School, Boston, and Georgetown University, Washington, DC, finds that hospital compliance with the Centers for Medicare & Medicaid Services (CMS) 2021 Price Transparency Rule is increasing since financial penalties were enforced. Data from 4,377 acute care hospitals operating in 2021 and 2022 were…
Editor's Note The Centers for Medicare & Medicaid Services, on April 26, announced updates to the enforcement process for its hospital price transparency rule. CMS will now automatically impose a civil monetary penalty if hospitals do not submit a corrective action plan on time or complete it within 45 days.…