A new rule going into effect on January 1, 2019, will require all hospitals to post a master list of standard prices online, as well as make electronic medical records more readily available to patients. The new rule called, Inpatient Prospective Payment System is part of the Medicare program that is aimed at pricing transparency across the healthcare system.
The requirement was introduced in the Affordable Care Act of 2010. In March, the head of Centers for Medicare and Medicaid Service, Seema Verma, stated the new requirement for online prices reflects the Trump Administration’s ongoing efforts to “encourage patients to become better-educated decision makers in their own care.”
Hospitals are already required to disclose prices publicly, but this new law will put the information online in a machine-readable format that is easily processed by computers. In the past, hospitals have been quiet when it comes to price lists claiming they contain proprietary information that could be too confusing for patients.
— WebMD (@WebMD) December 27, 2018
Unfortunately, the law may still be confusing to some, since standard rates are like list prices and don’t reflect what government or issues programs pay. Patients concerned about their potential out-of-pocket cost from being in the hospital would still be advised to consult the insurance company they are with and follow their health plans. Most insurance plans have an annual limit on how much patients must pay in deductibles and copays, but traditional Medicare doesn’t which is why the final cost might vary for patients.
Although in most cases, health care providers already make computerized records available to patients, starting in 2021, Medicare would base part of a hospital’s payment on how “good a job” they do at the tasks. Hospitals must be required to update these price lists at least once a year.