The Trump administration released 3 proposed rules yesterday that would shine a light on how hospitals negotiate with health insurers and further cut payment rates for some doctor services, Axios' Bob Herman reports.
The big picture: The long-debated policy is now here — hospitals have to start publishing their negotiated payment rates with every commercial insurer for at least 300 services or face a maximum fine of $300 per day. (Read the rule.)
- The rule would also finish its phase-in of lower payments for basic doctor visits performed in hospital-owned clinics, which we previewed last week.
- Total spending: $79 billion in outpatient payments, up $6 billion from this year.
What they're saying: "Disclosing the negotiated rate between insurers and hospitals will not help patients make decisions about their care. Instead, this disclosure could harm patients by reducing patient access to care," several hospital groups said in a statement.
Medicare’s physician rule: The rule is again loaded with adjustments to how every physician specialty is paid, based in large part on what the American Medical Association says.
- Notably, Medicare says it will pay more for primary care doctors to spend more time with chronically ill patients.
Medicare’s kidney care rule: Medicare expects to dish out $11.1 billion in dialysis-related payments in 2020, $210 million higher than what is expected this year.
The bottom line: Some of the most dramatic health policy changes don’t happen in Congress. They happen in these annual payment rules from the Centers for Medicare & Medicaid Services.
Reach out to us: We’ll be reading through the rules over the coming days, but if you find some surprising Easter eggs, let us know: email@example.com, firstname.lastname@example.org, email@example.com. 📷