�Թϲ�����

The White House released an executive order Monday afternoon intended to require insurance companies, doctors and hospitals to give patients more information about precisely what their care will cost before they get it. President Trump announced the new policy at a signing event, flanked by doctors and patients who had been hit by unexpected medical bills. The event came a week after the official launch of his re-election campaign, and it allows the president to make a claim that he is pursuing a far-reaching health reform plan, his answer to voter concerns about the high costs of care. (Abelson and Sanger-Katz, 6/24)

The idea is to give patients practical information that they can use to save money. For example, if a hospital charges your insurer $3,500 for a type of echocardiogram and the same test costs $550 in a doctor's office, you might go for the lower-price procedure to save on copays. But insurers said the idea could backfire, prompting hospitals that now give deeper discounts to try to raise their own negotiated prices to match what high earners are getting. Hospitals were skeptical of the move. (Alonso-Zaldivar, 6/24)

While President Trump has pledged repeatedly to take on health costs, the signing of the executive order unleashes coordinated efforts from multiple agencies to pursue the goal. It calls for the Department of Health and Human Services to issue a rule within two months that could require hospitals to publicize information on their negotiated rates with insurers for common procedures. (Armour and Wilde Mathews, 6/24)

The order also calls for a roadmap for consolidating quality metrics across all federal health care programs, expanding access to health care claims data de-identified to preserve privacy and directs the Treasury Department to expand the availability of health savings accounts to pay for more health care services. The administration had hinted it would require hospitals and insurers to disclose their negotiated rates — a prospect that triggered fierce pushback from the both industries. But how specific that information will be is up in the air. Senior administration officials said the executive order will call for a proposed rule to make public information based on negotiated rates, with the level of detail to be hammered out in the rulemaking process. (Roubein, 6/24)

“No Americans should be blindsided by bills for medical services they never agreed to in advance,” the president said in a signing ceremony in the White House’s grand foyer. “We are fundamentally changing the nature of the health-care marketplace . . . This is a truly big action. People have no idea how big it is. Some people say bigger than health care itself.” (Goldstein, 6/24)

“Access to this data will also enable researchers and entrepreneurs to locate inefficiencies and opportunities for improvement, such as patterns of performance of medical procedures that are outside the recommended standards of care,” the White House said in the executive order.  The order also directs HHS to make a list of priority datasets that, if de-identified, could advance the policies set forth by Trump, the order said. (Young, 6/24)

The administration took a step toward more transparency earlier this year by requiring hospitals to post their list prices, known as the chargemaster, online. That information, designated with arcane billing codes, is hard for consumers to decipher. Few people actually pay the list prices, which can be multiples higher than insurers’ contracted rates. Prices paid by private insurers can be many times the amounts paid by Medicare, the government health-insurance program for older Americans, research by health economists has found. Contracted rates can also vary wildly among health plans and providers, meaning that the same test or procedure could be vastly more expensive at different facilities in the same city. (Tozzi and Pettypiece, 6/24)

Azar said the rules would drive down prices because it would empower patients to shop around for the best costs. The administration says that is difficult to do in the current health care system because hospitals and providers often do not provide quotes for services. “Everyday American patients are being taken advantage of by a system that hides critical information from them that they need to make decisions for them and their families,” Azar said. (Hellmann, 6/24)

One source familiar with the discussions said Azar and White House officials clashed over the level of detail hospitals and insurers should have to disclose about their negotiated rates. The White House wanted the language to be much more specific than the final result while Azar wanted to mitigate industry opposition. (Luthi, 6/24)

Some consumer advocates welcomed the move. "Today patients don't have access to prices or choices or even ability to see quality," said Cynthia Fisher, founder of a group called Patient Rights Advocate. "I think the exciting part of this executive order is the President and administration are really moving to put the patient in the driver's seat and be empowered for the first time with knowledge and information." (Keith and Simmons-Duffin, 6/24)

Kaiser Health News: Trump Administration Seeks More Health Care Cost Details For Consumers

Much depends on how the administration writes the rules governing what information must be provided, such as whether it will include hospital-specific prices, regional averages or other measures. While the administration calls for a “consumer-friendly” format, it’s not clear how such a massive amount of data — potentially negotiated price information from thousands of hospitals and insurers for tens of thousands of services — will be presented to consumers. “It’s well intended, but may grossly overestimate the ability of the average patient to decipher this information overload,” said Dan Ward, a vice president at Waystar, a health care payments service. (Appleby, 6/24)

A senior administration official called the concerns by hospitals and insurers overblown. The negotiated rates are sent to customers after the services are rendered, the official said, so the information is already out there. If the administration’s rules are finalized, patients would simply have the information in advance. “Every time any one of us goes to a doctor or a hospital, within a couple of weeks in our mailbox arrives an explanation of benefits that contains the list price, the negotiated rate between plan and provider, and what our out of pocket is,” the official said. “This is not some state secret.” (Siddons, 6/24)

It makes intuitive sense — publish prices negotiated within the health care industry, and consumers will benefit. That’s the argument behind the executive order issued Monday by President Donald Trump that is intended to give patients more information about what health care will cost before they get it. But the peculiarities of the United States health care system, with its longstanding secrecy around negotiated health care prices, mean there is very little research on the possible effects of the particular thing the Trump administration wants to do. (Sanger-Katz, 6/24)

On Monday, President Trump issued executive orders requiring greater transparency around medical costs. But will they help? Nick Schifrin talks to Elisabeth Rosenthal of Kaiser Health News. (6/24)