Comment letters submitted on IPPS proposed rule and price transparency

The South Dakota Association of Healthcare Organizations supports two letters recently submitted by the American Hospital Association to the Centers for Medicare & Medicaid Services.

The first comment letter relates to the Centers for Medicare & Medicaid Services’ (CMS) federal fiscal year (FFY) 2019 inpatient prospective payment system proposed rule. The letter offers key recommendations with respect to Medicare Disproportionate Share Hospital payment, CAR T-cell therapy, rural hospitals, the wage index, hospital quality reporting and value programs and electronic health information exchange.

The second comment letter recommends that CMS convene a multi-stakeholder process to advance price transparency in health care. 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 benefits and beneficiary cost-sharing amounts; rather, insurers hold this information.

SDAHO will continue to monitor these issues and provide additional information as it become available.