Figuring out Hospital Prices is next to impossible… but that is about to change. One great accomplishment of 2020 is that new efforts emerged to create transparency between hospitals and insurance carriers. Despite the American Hospital Association’s fight to keep people in the dark, new requirements imposed by CMS require hospitals to publicly disclose pricing in a comprehensive machine-readable file or through a consumer-friendly cost estimator tool.
While the hospitals are only required to provide a total cost based on this rule, the Department of Health and Human Services, the Department of Labor, and the Department of the Treasury promulgated a final rule on October 29, 2020, that will require health plans to disclose the price and cost-sharing information to participants, beneficiaries, and enrollees. These departments also are finalizing a requirement to give consumers real-time, personalized access to cost-sharing information, including an estimate of their cost-sharing liability, through an internet-based self-service tool. With the court battles to transparency in the rearview mirror, the only remaining hurdle is compliance.