AHA Proposes Ways to Improve Health Care Price Transparency

AHA today recommended that the Centers for Medicare & Medicaid Services convene a multi-stakeholder process to advance price transparency in health care. “The AHA is committed to improving patients’ access to information on the price of their care,” the association wrote, responding to a CMS request for information on ways to make more useful price information available to consumers. “CMS’s updated guidelines may help some patients obtain pricing information; yet, numerous challenges must be overcome to provide accurate price estimates broadly. The provision of care is complex, and often the exact course of care is not knowable in advance. Moreover, individuals are more interested in knowing how much they will need to pay for their care or, more specifically, their out-of-pocket costs. Yet hospitals, health systems and other providers do not have access to detailed data on health plan benefit and beneficiary cost-sharing amounts; rather, insurers hold this information. We recommend that the agency convene a multi-stakeholder process to discuss how we can work together to improve price transparency, the sharing of information on health plan benefit structure and cost-sharing amounts, and overall health care literacy.” AHA also encouraged software developers and other technical experts to work with providers and insurers on tools they can use to help respond to patient pricing inquiries.