But our price transparency announcement may be a more significant improvement to American healthcare markets than any other single thing the Trump administration has done—and perhaps the most transformative shift toward patient control in healthcare that any President has ever enacted.
As Prepared for Delivery
President Trump has a huge range of healthcare accomplishments. We're announcing new ways to improve the American people's healthcare, and their health, just about every week.
But our price transparency announcement may be a more significant improvement to American healthcare markets than any other single thing the Trump administration has done—and perhaps the most transformative shift toward patient control in healthcare that any President has ever enacted.
The President has made four healthcare promises, as Joe mentioned: protecting vulnerable patients, like those with preexisting conditions; and delivering the affordability you need, the options and control you want, and the quality you deserve.
There's only one way to deliver all those outcomes at once, and that is to derive better value from our system.
Driving toward value-based care has been a bipartisan priority for some time, but too often these efforts have left the patient out of the picture.
American patients have been at the mercy of a shadowy system, with little access to the information they need to make decisions about their own care.
From the beginning of President Trump's term, and my tenure as Secretary, we've been clear: This shadowy system has to change. The patient has to be in control. That requires giving the patient the right to know what they're going to owe for a healthcare service before they ever get it.
The vast majority of patients don't have easy access to this information today. But when they do, we see prices drop.
In one study, when prices for imaging were made transparent, prices dropped almost 20 percent, while price disparities across providers also narrowed.
We know that 70 percent of the most common hospital services already are shoppable. We also know that, in markets, it often only takes a minority of customers to be especially price-conscious consumers in order to drive price competition.
Shedding light on price information is absolutely vital not just to delivering better care at a lower price, but also to building the healthcare system the President has envisioned: a system that's not only affordable, but also personalized, patient-centric, puts you in control, and treats you like a person, not a number.
That's a stark contrast to the system we have today, which keeps patients in the dark about cost and quality information. According to one poll, 93 percent of Americans found themselves surprised by a healthcare bill in 2018. Two-thirds of healthcare providers cite price transparency as a limited or nonexistent priority within their organization.
If you've ever tried to find out the price of a healthcare service, and what you're going to owe for it out-of-pocket, you will not be surprised by those findings.
I'm the health secretary, and I've often found myself unable to get this information when I need care!
We know this information matters to patients: One poll found that almost two-thirds of patients now rate cost as important or extremely important when considering whether to follow a doctor's recommendation.
President Trump has heard how frustrating it can be for patients to be kept in the dark about how much their healthcare is going to cost.
The President has promised A+ healthcare transparency. Right now, our system is not delivering the information patients need.
President Trump is going to change that, in what will be a transformative shift toward patient control of our healthcare system.
First, HHS, the Department of Labor, and the Department of the Treasury are proposing today to require that your insurer provide you with real-time access, via an online tool, to cost-sharing information: an estimate of what you would owe for all covered healthcare items and services.
This is information patients typically receive after they actually get those services, through an explanation of benefits.
We're also proposing to require that insurers' negotiated rates for in-network services, and their historically paid amounts for out-of-network services, be made publicly available to consumers, employers, researchers, and app developers. Researchers and entrepreneurs would be able to use this data to deliver comprehensive information to consumers about cost information for the care they need.
When I first identified transparency as a key part of value-based transformation, I said you should have the right to know what a healthcare service is going to cost, and what it's going to cost you, out-of-pocket. That's what our proposed insurer rule will do.
Second, we're finalizing a rule to require that, starting January 2021, hospitals will have to disclose publicly their negotiated rates for services, as well as the discounted cash price they're willing to take.
For the most common shoppable procedures, this information will have to be available in an easily accessible, patient-friendly format.
For all procedures, this information will have to be posted online in a machine-readable format, so that it can be incorporated into third-party tools such as smartphone apps.
The top priority is making this information as accessible and usable for patients as possible.
Hospitals will have to place the price information for common procedures in a prominent place online, in plain language, in a searchable format. A procedure's price will have to be grouped with the charges for any ancillary services the hospital customarily provides with that service.
Our two announcements today are historic changes to the power of American patients to take control of their care and get better value in healthcare.
But there are more steps to come, too: We're also working to put patients in control of their own health data, through interoperable health IT; to provide more usable quality information; and to reform payments so we're paying for outcomes, rather than procedures.
Putting all these efforts together, President Trump is delivering a new era of transparent, affordable healthcare, with the American patient in control.
CMS has been pursuing every avenue we have to put patients in control. So, I'll now hand things over to Administrator Verma to explain some more details on these two rules and how they fit into all of CMS's work on transparency.
