Improving Price and Quality Transparency in American Healthcare To Put Patients First
Jun 27, 2019
Signed by: Donald Trump
Signed on: Jun 24, 2019
Published on: Jun 27, 2019
Jun 27, 2019
Signed by: Donald Trump
Signed on: Jun 24, 2019
Published on: Jun 27, 2019
Summary
Requires hospitals and insurers to show prices for services, helping patients make better choices and avoid surprise bills.
What problem does this solve?
Patients often don't know the cost of healthcare before they get it, which can lead to high prices and unexpected bills. This order forces hospitals and insurance companies to be open about their prices, so people can compare costs and choose the best care for them.
What does this order do?
Requires hospitals to post prices publicly
Directs the Secretary of Health and Human Services to create a rule requiring hospitals to post their standard charges, including rates negotiated with insurers, in a format that is easy for consumers to understand.
Provides patients with out-of-pocket cost estimates
Asks federal agencies to develop rules that require healthcare providers and insurance plans to give patients information on their expected out-of-pocket costs before they receive care.
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Increasing access to data to make healthcare information more transparent
Increases access to healthcare data
Orders federal agencies to make de-identified health claims data from government programs available to researchers and innovators. This is intended to help them find ways to improve the healthcare system.
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Empowering patients by enhancing control over their healthcare resources
Expands use of health savings accounts (HSAs)
Directs the Secretary of the Treasury to issue guidance making it easier for people with high-deductible health plans and HSAs to get coverage for low-cost preventive care for chronic conditions before meeting their deductible.
Addresses surprise medical billing
Requires the Secretary of Health and Human Services to report on what additional steps the administration can take to protect patients from surprise medical bills.
Creates a Health Quality Roadmap
Directs several federal departments to develop a plan to align and improve how healthcare quality is measured and reported across different government health programs like Medicare and Medicaid.
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Empowering patients by enhancing control over their healthcare resources
Increases carry-over for flexible spending arrangements (FSAs)
Asks the Secretary of the Treasury to issue guidance that increases the amount of money people can carry over to the next year in their FSAs.
Who does this affect?
- Patients
- Hospitals
- Health Insurance Companies
What is the real world impact?
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Empowers patients with information
Gives patients access to price and quality data, allowing them to shop for healthcare services like they would for other goods. This can help them find better value and avoid surprise medical bills.
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Increases market competition
Aims to lower overall healthcare costs by forcing hospitals and insurance companies to compete on price and quality. When prices are public, providers may lower them to attract more patients.
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Shifts more financial responsibility to patients
Encourages the use of high-deductible health plans and savings accounts. Critics might argue this places a greater financial burden on individuals to manage their healthcare costs, which can be difficult for those with chronic conditions or unexpected medical needs.
When does this start?
This order sets several deadlines for federal agencies to propose new rules and reports.
Rule on hospital price transparency
Within 60 days of June 24, 2019, the Secretary of Health and Human Services must propose a regulation requiring hospitals to post their prices.
Rule on out-of-pocket cost estimates
Within 90 days of June 24, 2019, several agencies must issue a notice for a proposal to require providers and insurers to give patients out-of-pocket cost estimates.
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Empowering patients by enhancing control over their healthcare resources
Guidance on Health Savings Accounts (HSAs)
Within 120 days of June 24, 2019, the Secretary of the Treasury must issue guidance to expand the use of HSAs with high-deductible plans.
Report on barriers to price transparency
Within 180 days of June 24, 2019, the Secretary of Health and Human Services must issue a report on what is blocking price transparency.
Development of Health Quality Roadmap
Within 180 days of June 24, 2019, several agencies must develop a roadmap to improve and align health quality reporting.
Report on surprise medical billing
Within 180 days of June 24, 2019, the Secretary of Health and Human Services must submit a report on further steps to address surprise billing.