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CMS Increases Pricing Transparency, Requires Hospitals to Post Prices Online

September 2018

The Centers for Medicare and Medicaid Services (CMS) has issued a final rule on the Inpatient Prospective Payment System (IPPS) that increases pricing transparency by pushing hospitals to post standard charges online in a machine-readable format.

“While CMS previously required hospitals to make publicly available a list of their standard charges or their policies for allowing the public to view this list upon request, CMS has updated its guidelines to specifically require hospitals to post this information on the Internet in a machine-readable format,” according to an agency press release.

Although CMS will not require hospitals to post additional information than what is already mandated, the agency has issued a request for information that seeks input on furthering pricing transparency. Additionally, the agency noted that future actions based on public feedback will be used to create patient-friendly interfaces that allow consumers to more easily access relevant health care data and compare providers.

Also included in the final rule was an increase in payment rates for general acute hospitals paid under IPPS by about 1.85%, an increase from 1.75%. Further, payments for long-term care hospitals have also increased 1.35%, up from 1.15%.

CMS estimates that these rate hikes will increase Medicare spending on inpatient hospital services by roughly $4.8 billion in 2019 compared with an April 2018 estimate of $4 billion.

“We’ve listened to patients and their doctors who urged us to remove the obstacles getting in the way of quality care and positive health outcomes,” Seema Verma, MPH, CMS administrator, said. “Today’s final rule reflects public feedback on CMS proposals issued in April, and the agency’s patient-driven priorities of improving the quality and safety of care, advancing health information exchange and usability, and removing outdated or redundant regulations on healthcare providers to make way for innovation and greater value.”—Julie Gould