Last Updated: Jun 24, 2019
The following is a statement from Danae Powers, MD, president of the Pennsylvania Medical Society (PAMED). It is a reaction to President Trump’s executive order that aims to foster greater price transparency from health systems and insurers.
PAMED supports the goal of price transparency and helping patients make informed decisions about their care. We appreciate President Trump making cost transparency a priority, but PAMED needs to examine his executive order in more detail before providing further comment.
In general, our member physicians tell us their patients care most about out-of-pocket costs for a given office visit, test, procedure, or other medical treatment. This is something that physicians are usually not able to determine, as it depends on their patients’ insurance policy.
Thus, insurers play the most critical role in educating patients on that cost information.
For cost info to be useful, insurers must make it available to patients and physicians in an easy-to-understand format.
The American Medical Association has recommended cost information be made available by insurers through a patient’s electronic health record (EHR). Currently, the only way for a physician office to assist a patient would be to contact a patient’s health plan directly to inquire about the share of costs for a particular service or procedure.
In addition, the Pennsylvania Medical Society supports requiring private insurers to allow physicians to log in with personal identifying information and learn what their reimbursement rate is for any product and code the physician has agreed to by contract, in a similar fashion as currently offered by Medicare. This will also enable physician offices to better inform patients about out-of-pocket costs and copays.
PAMED looks forward to further movement regarding the issue of price transparency
and patient protection.
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Pennsylvania Medical Society
The Pennsylvania Medical Society helps its 20,000 physician and medical student members return to the art of medicine through advocacy and education. Learn more by visiting www.pamedsoc.org
or by following us on Twitter at @PAMEDSociety.