Michigan Association of Health Plans

CMS seeks help creating consumer price comparison tool

The CMS started the process of searching for a company to help create a price comparison tool for consumers.

It has released a sources sought notice to see if any companies have the expertise to perform such work. A formal request for proposals for the work could be released later depending on the responses the agency receives to the CMS query on what would be a transparency-focused web portal.

Interested companies must respond by Sept. 24.

The notice comes as the CMS is pushing hospitals to be more transparent about what they charge patients. The agency has updated its previous price transparency guideline, drawn from the Affordable Care Act, by requiring hospitals to publish a list of standard charges in an online, machine-readable format starting Jan. 1. They must update that charge information, drawn from their retail chargemaster list, at least annually.

It’s unclear if the two initiatives are linked. The CMS said this month in a rulemaking that it’s considering future actions on how hospitals can best display price information that would be most useful to consumers, allowing them to more easily compare providers on price and quality.

A CMS spokesman confirmed the notice was about potentially offering a contract for price transparency services but could not comment further.

Contractors responding to the sources sought notice must have experience with transmitting and storing medical provider information and using bid or auction data for healthcare procedures. Responding companies should also have specific experience supporting provider pricing and transparency efforts and currently offer support for the development and maintenance of web-based price comparison tools, bidding systems and applications.

Steven Weissman, an attorney and former hospital president, expressed disappointment after seeing the sources sought notice. He doesn’t think any potential hospital price comparison tool will ultimately help consumers.

“Ask any hospital, lab or physician the price of anything and all you ever get back is a question: ‘What insurance do you have?’ ” Weissman said. “Each patient’s price depends on how much can be extracted.”

The American Hospital Association and other hospital industry backer have mirrored these remarks. They argue that payers should be the primary source of information for patients about prices and out-of-pocket costs. They also said data on charges and payments from providers are proprietary, and that such information would not be useful to consumers interested in what they will have to pay out of pocket.

But the CMS rejected those arguments in a rulemaking this month, saying nothing justifies a delay in the provision of chargemaster information to the public.

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