How Has Last Year’s Executive Order Changed Medical Price Transparency?

It’s true that President Trump has taken a fair share of criticism in his approach to fixing the healthcare crisis in America. Yet, he has taken some steps that are positive. The executive order that he signed into law last summer is one such example. It sought to fix a few problems plaguing the average American looking for medical care.

The executive order seeks to encourage price transparency from medical providers. Through this change, one hopes that competition results and lower prices arise.

Did this executive order create the change it was intended to? How are things looking one full year later? Read on and we’ll walk you through what you need to know.

What Is Price Transparency? 

A patient goes to see a doctor because of a problem or rushes to the hospital because of a serious emergency. The location is in her plan’s network. They receive treatment. Weeks later, they receive a bill that indicates that they owe thousands of dollars for this medical care.

Even though they had coverage!

While this might sound horrifying, this is the reality for many who seek medical care in the United States. Medical billing is a complicated business and one that seems to take place entirely behind closed doors.

It’s common for a consumer to only find out how much they’ll need to pay after they already owe money for the services. This is one of the many reasons that so many Americans get burdened with an immense amount of medical debt.

It’s hard to plan and budget for a huge sum that you don’t even see coming.

The concept of price transparency, at least as defined under President Trump’s Executive Order? A requirement for medical providers to share pricing information with consumers ahead of time.

Not all medical procedures and goods will have a consistent price, as much of medical care is a case-by-case game. Still, pricing transparency seeks to put out standard charge information. Prices can be listed for common health care items and services.

Advantages and Disadvantages

What did those advocating for pricing transparency hope to see? They want patients to have a sense of what their financial responsibility might be. They want them to know this before receiving health services.

The hope would be that consumers would then take the time to ‘shop around’ between different medical providers, hunting for the best price. Medical providers will want the business, so they’ll lower prices to keep competitive and lure in the consumers who’s business they need.

In concept, this is how pricing transparency is intended to help the consumer and lower costs. 

Those who oppose pricing transparency as a solution argue that this information being in the open will remove the ability of third-party payers to bargain with medical providers. Some believe that transparency in pricing might actually drive up prices instead of lower them.

Information exchanges in markets as concentrated as medical care are hard to control. There can be coordination between price-makers that are difficult to detect and therefore hard to outlaw under existing anti-trust laws.

These changes still put the power in the hands of medical provides, who some argue don’t have the best interests of the American people at heart. 

President Trump’s Executive Order

It was June of 2019 when President Trump issued an executive order from the White House on the matter of pricing transparency.

The order required hospitals to provide standard charge information. It also set forth a set of requirements for many government entities as well. The Department of Health and Human Services was also tasked with developing rules and disclosure requirements for hospitals.

This way, the information released would be consistent and easy to understand. 

The Department of Treasury and Department of Labor were also given a job. They are developing an advanced notice of proposed rulemaking for medical providers. That is to say, they are reaching out and notifying the appropriate parties about changes in requirements.

The Department of Health and Human Services was also to continue to do research and report to the president on additional steps that could be taken to help fight surprise medical bills.

Some proposed ideas the HHS came up with included capping out-of-network costs and increased transparency in terms of which providers are in and out of network. 

What Has Changed?

A year later, and what impact has the Executive Order had on medical price transparency? It’s not easy to answer.

For one, the full extent of the White House’s Executive Order won’t be implemented until January of 2021. That means many medical providers might still be working towards creating a better system of transparency for their consumers.

Much of the work that’s out there currently in terms of pricing transparency was already initiated before the release of President Trump’s EO. Consumer complaints about surprise pricing and the medical debt crisis have pushed many in the field to consider solutions on their own.

This has given many a head start on the requirements laid out by the White House. The future is sure to bring more positive change for those seeking medical help.

Fighting for Healthcare Transparency

It’s no secret that many consumers are not happy with the way that healthcare billing works in America. President Trump’s Executive Order is an attempt to solve the issue of price transparency with medical providers, and only time will tell if it is truly successful.

Have more questions about what’s happening around the country? Want to stay in the know? Keep scrolling our blog for more.

All opinions expressed on USDR are those of the author and not necessarily those of US Daily Review.