President Donald Trump said Wednesday that he wants to take action to protect Americans against surprise health care bill.
Trump talked about balance billing — or cases in which patients get much higher bills than expected, often because they have inadvertently received care from out-of-network providers, or from providers in the wrong network coverage tier — in the White House, at a round table discussion on transparency in health care pricing.
(Related: Mysterious $1,000 Lab Bills Baffle Patients)
The federal government started requiring hospitals to post the list prices of their services online Jan. 1.
Trump said his administration has already stopped a lot of the pricing surprise problems through the price transparency measure. ”
“ We’re going to stop all of it,” Trump said. “It is very important to me.”
Trump cited a reporting showing that 40% of insured adults have reported receiving a surprise medical bill in the past year.
“Patients should know they real price,” Trump said. “They go in, they have a procedure, and then all of a sudden they can’t afford it. They had no idea it was so bad.”
Alex Azar II, the secretary of the U.S. Department of Health and Human Services (HHS), said the cure for the problem is tougher price disclosure rules.
“Like all of the Trump administration, HHS knows the right way to bring down costs while improving quality in any area is to empower consumers and to employ market forces,” Azar said. “This can’t be accomplished without transparent pricing information. It’s got to be meaningful price signals. But, in health care, prices are often hidden, far out of line with what many patients will owe, or both.”
Azar recalled one occasion, several years ago, when he was using a health savings account of his own to pay for his own routine diagnostic test.
At that time, he already had a stint as an HHS deputy secretary on his resume.
“I asked [the doctor] how much it would cos,” Azar said at the round table discussion. “Do you know what I was told? ‘We can’t tell you.’ Well, because I was a former deputy secretary of HHS, I pushed and pushed, and … and I said, ‘You’re going to tell me what this is going to cost.’ And eventually, he told me: $5,500.”
Azar said he went on the web and found that, if the same test were done in a doctor’s office, it should cost just $550.
Azar said he then wondered what the cost of the procedure in the hospital would be with the health plan’s discount applied.
Azar asked the hospital, “What will I pay, given my insurance company?”
Azar said the hospital refused to tell him what the discounted price would be.
“I fought, and fought, and fought,” Azar said, “And, eventually, they told me: $3,500. So, armed with that information, I took the plastic wristband off and walked out of the facility, and didn’t get the test done.”
Azar said a current area of concerns is allocations of drug price rebates between health plans, pharmacy benefit managers and consumers.
“We’re concerned that patients and payers are left in the dark about the hundreds of billions of dollars in rebates being paid from drug manufacturers to pharmacy benefit managers, or so-called middlemen,” Azar said. “These payments are non-transparent and they distort these prices, and create bad incentives in our system.”
A written transcript of the round table discussion is available here.
A video of the hearing is available here.
— Read States Take Aim at Surprise ER Bills, on ThinkAdvisor.