IPPS proposed rule pushes for more price transparency

One provision tucked into Centers for Medicare & Medicaid Services' proposed Inpatient Prospective Payment System (IPPS) proposed rule would push hospitals further down the road toward price transparency.

The provision tries to comport with a provision in the Affordable Care Act that requires hospitals to post their overall and DRG-related prices for public consumption. Hospitals should either "make public a list of their standard charges (whether that be the chargemaster itself or in another form of their choice), or their policies for allowing the public to view a list of those charges" when an inquiry is made, the rule states.

"We believe that providing charge data comparisons is introducing both transparency and accountability to hospital pricing, and we are continuing to pursue opportunities to report on hospital charging practices," CMS said in its nearly 1,700-page rule.

Later in the document, CMS encourages hospitals "to undertake efforts to engage in consumer friendly communication of their charges to help patients understand what their potential financial liability might be for services they obtain at the hospital, and to enable patients to compare charges for similar services across hospitals. We expect that hospitals will update the information at least annually, or more often as appropriate."

Hospital pricing practices came under fire last year when Time magazine reported that many hospitals all but disregard their chargemasters when it comes to how they operate.

The agency itself also tried to promote price transparency last year when it published  the 100 most-often billed DRGs at hospitals that participate in the Medicare program, as well as what it pays hospitals  for those procedures. Last month, it published most of the payments made to individual physicians and other providers who participate in Medicare. Payments diverge greatly, depending on the provider and the geographic region.

To learn more:
- here's CMS's proposed rule (.pdf)