Biden Administration Likely to Require "Open System" Price Estimator Tools
Yesterday, the Biden Administration sent a letter to the Supreme Court stating it is dropping any legal action to invalidate the Affordable Care Act (ACA). This is no surprise. Howevever, this action has powerful implications for the Biden Administration's support for healthcare price transparency.
One of the pillar stones of the ACA is an open marketplace where consumers and businesses can shop among plans. As an example, the Affordable Care Act created the Small Business Health Options Program (SHOP), an insurance exchange designed to help small businesses compare the costs of health plans and enroll in coverage for their employees.
What happens next with price transparency?
According to our sources, the Biden Administration will make the following statements in the near future:
Reiterate its support for healthcare price transparency, with the emphasis that the ability to shop plans will ensure the long term stability of the ACA
Revise guidelines on price estimator tools, forcing estimates to be "open system" as opposed to "closed system". At present, some price estimator tools provide plan-specific estimates only if you're a current member of the plan. In other words, if you're a member of Blue Cross, you can't get an estimate for Cigna.
See example "open system" price estimator installed at Maine General Medical Center (scroll down to "Use the EZCOST Cost Estimate Tool" button), and experience firsthand why Apple co-founder Steve Wozniak and Shark Tank's Kevin O'Leary ("Mr. Wonderful") think EZCOST is the most consumer friendly price estimator tool in the market.
Still not compliant? Contact us... we can help!
Working with the CMS guidelines, HPS estimates that more than half of U.S. hospitals are not fully compliant with the new price transparency rules. Besides the $300/day fine and being listed on CMS's website as a non-compliant hospital, the greater risk is a nasty news story that says your hospital is intentionally avoiding price transparency. It's already happening.
If you would like HPS to take a confidential vulnerability audit assessment of your consumer-friendly 300 shoppables application and machine-readable file, please schedule a free meeting on my private calendar: go.oncehub.com/ricklouie