Texas Health Resources is part of a new lobbying alliance. Photo: Texas Health Resources

Several hospital systems are lobbying Medicare to stop basing certain payments on their sticker prices, also known as "chargemasters" — prices the Trump administration has required them to disclose publicly.

The intrigue: Hospitals aren't advocating for lower Medicare payments. They want to reduce the prices they list publicly, while retaining the same Medicare revenues.

How it works: Hospitals have a chargemaster that lists the rack rates of every service, test and procedure.

  • Those prices are relevant for people who are uninsured and for people who get out-of-network services, but they don't reflect the net price that's negotiated with private health insurers.
  • However, Medicare bases a handful of hospital payments based on those chargemaster prices — including things like "outlier" payments for patients who are extraordinarily expensive.

​Driving the news: Six hospital systems — Advent Health, Baptist Health, Geisinger, SSM Health, Texas Health Resources and Trinity Health — and the Healthcare Financial Management Association, a trade organization for hospital executives, are each paying $2,000 a month to fund the Chargemaster Alternatives for Medicare Payment Alliance.

  • They essentially want Medicare to do away with payment formulas that take those list prices into account.
  • Rick Gundling, a vice president at HFMA, said in an interview the changes would allow hospitals to "rationalize their charge structure" and "allow for better transparency."
  • The hospital systems either did not respond to requests for comment or did not make executives available for interviews.

The bottom line: Hospitals don't like having to post their high chargemaster rates. It's embarrassing, but they also argue the rates are misleading because they don't reflect patients' out-of-pocket costs.

  • If hospitals convince Medicare to calculate outlier and other niche payments on costs instead of charges, and guarantee the payments won't go down, they would get a PR win for potentially lowering some list prices and a financial win for not sacrificing revenue.

Go deeper

Updated 2 hours ago - Politics & Policy

Coronavirus dashboard

Illustration: Sarah Grillo/Axios

  1. Global: Total confirmed cases as of 3 a.m. ET: 19,648,084 — Total deaths: 727,024 — Total recoveries — 11,941,723Map.
  2. U.S.: Total confirmed cases as of 3 a.m. ET: 4,998,105 — Total deaths: 162,425 — Total recoveries: 1,643,118 — Total tests: 61,080,587Map.
  3. Politics: Trump signs 4 executive actions on coronavirus aid — Democrats, and some Republicans, criticize the move
  4. Public health: Fauci says chances are "not great" that COVID-19 vaccine will be 98% effective — 1 in 3 Americans would decline COVID-19 vaccine.
  5. Science: Indoor air is the next coronavirus frontline.
  6. Schools: How back-to-school is playing out in the South as coronavirus rages on — Princeton, Johns Hopkins, Howard to hold fall classes online.
Updated 4 hours ago - World

Brazil coronavirus death toll tops 100,000 and case numbers surpass 3 million

Brazilian President Jair Bolsonaro posted a photo of himself to Facebook congratulating his soccer team, Palmeiras, for winning the state title Saturday, moments after the health ministry confirmed the national COVID-19 death toll had surpassed 100,000.

Why it matters: Brazil is only the second country to confirm more than 100,000 deaths from the coronavirus. On Sunday morning, it became the second country to surpass 3 million cases, per Johns Hopkins. Only the U.S. has reported more. Bolsonaro has yet to address the milestones. He has previously tested positive for COVID-19 three times, but he's downplayed the impact of the virus, which has crippled Brazil's economy.

Editor's note: This article has been updated with the latest coronavirus case numbers and more context.

Updated 6 hours ago - Politics & Policy

Republicans and Democrats react to Trump's coronavirus aid action

President Trump speaks to workers at a manufacturing facility in Clyde, Ohio, on Thursday. Photo: Scott Olson/Getty Images

Some Republicans joined Democrats in criticizing President Trump Saturday night for taking executive action on coronavirus aid, with Democratic leaders demanding the GOP return to negotiations after stimulus package talks broke down a day earlier.

Why it matters: Trump could face legal challenges on his ability to act without congressional approval, where the constitutional power lies on federal spending. Sen. Ben Sasse (R-Neb.) was the most vocal Republican critic, saying in a statement: "The pen-and-phone theory of executive lawmaking is unconstitutional slop."