- Increase Hospital Price Transparency so patients know what a procedure costs before insurance pays for it. Employers pay into their employees’ health insurance with very little insight into what services their payments cover. Transparent hospital pricing would empower patients to become consumers once again in their health care. Patients will be able to steer their care toward high-value providers and push back on inflated rates that drive premiums up. The Patients Deserve Price Tags Act (S. 2355/H.R. 5582) would improve the transparency of healthcare costs, so patients understand the true price of procedures, medications, and services before receiving them.
- Implement Site-Neutral Payments to slow hospital consolidation. Small business owners would benefit from moving the commercial market toward site-neutral payment policies, which studies find would reduce health expenditures and result in lower premiums and cost sharing. Congress should discourage off-campus hospital outpatient departments (HOPDs) from billing add-on hospital fees. This would lower out-of-pocket costs and disincentivize consolidation in the hospital market. Further, doctors’ offices owned by a health care system should be required to use a separate and unique National Provider Identifier (NPI) number, and bill correctly so payors can differentiate between services delivered in a hospital and non-hospital setting and apply the appropriate reimbursement rates.
- Ban Spread Pricing and increase Pharmacy Benefit Manager (PBM) transparency. Banning spread pricing of prescription drugs would lower costs for business owners by allowing rebates on pharmaceuticals to flow from the manufacturer to the patient. PBM transparency will ensure that consumers will be able to see where the money they spend on prescription drugs goes.
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