The first attempt to craft a bill requiring transparency in healthcare billing is receiving mostly positive grades from industry watchers.
The bill (HR 6053) proposed by Rep. Michael Burgess (R-Texas) would amend the Social Security Act to provide for increased price transparency of hospital information and additional research on consumer information on charges and out-of-pocket costs.
The bill, introduced on September 12, had nine co-sponsors as of early October. It has been referred to the House's Subcommittee on Health, chaired by Rep. Joe Barton (R-Texas).
While there is virtually no chance for the bill to make it through Congress before year's end, it drew support from industry groups who predicted that it would be reintroduced in the next session of Congress, along with similar legislation.
"As bills go, it looks pretty good," said Laura Noble, director of policy for the Healthcare Financial Management Association of Westchester, Ill. "We expect it to be reintroduced, and we expect it to evolve."
Burgess' legislation has three components. First, it would require hospitals to publicly report inpatient and outpatient charge information. Next, it would require insurers to provide enrollees with information on expected healthcare costs.
Finally, it would require the Agency for Healthcare Quality and Research to study the type of information that consumers could find useful on charges and out-of-pocket costs for healthcare services.
The bill briefly mentions state initiatives related to transparent pricing, and the American Hospital Association sees that as an important part of any federal legislation. Some 32 states already have regulations mandating that hospitals provide pricing information; six states have voluntary price reporting.
The proposal provides more concrete provisions than the initiative announced by President Bush in February, said Ashley Thompson, director of policy for the AHA.
It's difficult to know what information is most useful for consumers, although growing evidence suggests they want to know out-of-pocket expenses, especially as consumers take on more responsibility for paying high deductibles out of health savings accounts, she said.
"Due to human biology, I don't think we'll ever get to true transparency," she said. "It's difficult to give people a true estimate of what their costs are going to be."
The HFMA would like to see more attention paid to systemic issues that have caused the complexity, said the HFMA's Noble.
"There's a lot that can be done regarding complexity," she said, citing HFMA's Patient Friendly Billing initiative. "We've been focusing on assessing what our members can do by themselves and what individual hospitals can do to improve price transparency."