On Thursday, Jan. 10, Seema Verma, administrator for the Centers for Medicare and Medicaid Services, held a telephone conference to discuss CMS efforts to build greater transparency of medical costs. The purpose is to offer patients more information about the cost of prospective procedures and surgery, thus allowing them to include the cost of the procedure in their decision.
In a federal rule approved in August 2018 and effective Jan. 1, hospitals are required to make public their charges. These must be posted on the Internet in a machine readable format.
“My goal is patients are first,” Verma said, describing the rule’s purpose. “This is a potential driving force for quality and value [of medical service]. Health costs are sky rocketing and the status quo is unacceptable.”
Verma envisions that patients will be able to access information on the costs of their treatment and combine it with quality measures being developed, thus seeking the best service for the lowest costs.
Currently, hospital charges for the same procedure or treatment can vary by 50 to 75 percent within the same geographical area. However, she noted that these are the basic publicly announced costs and are not what a hospital may charge an insurance company.
“This denies the patient the ability to make a value-based decision,” Verma lamented. “Our intention is that this is the first step. Hospitals can go further.”
Requiring the price data to be in a machine readable format, CMS hopes that third parties will develop software or applications that can use this data, combine it with other accessible data to improve patients’ ability to compare and make a health decision that includes costs as part of the mechanism.
“CMS wants to make healthcare costs more affordable through price transparency,” she stressed. “This is the first step to make it understandable to the patient.”
As of Monday morning, Jan. 14, this information was not found online for Desert Regional, Eisenhower, Hemet Valley, Loma Linda University or Menifee Valley medical centers. Several hospital representatives were not aware of the requirement.

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