American College Of Surgeons - Inspiring Quality: Highest Standards, Better Outcomes

ACS Comments on Payor Price Transparency Proposed Rule

The American College of Surgeons (ACS) submitted a comment letter to the Centers for Medicare & Medicaid Services (CMS) January 29 in response to the agency’s Transparency in Coverage proposed rule. In this rule, CMS specifically sought feedback on approaches to make health care price information accessible to consumers.

In its letter, the College offered guidance to CMS on methods to enhance the usability and accuracy of cost-sharing data private payors present to their enrollees. The ACS recommended the following: price information should reflect both the cost of an entire episode of care, as well as patient-specific insurance benefits; payors should be required to notify consumers about any prerequisites to coverage in a timely manner; and payors’ online self-service tools should be configured to allow users to search for cost-sharing information for a given item or service using various refining functionalities, such as physician network status, specialty, and quality rating. The College also highlighted its collaboration with the PACES Center for Value in Healthcare to create an environment of greater price transparency for patients by developing standard definitions for episodes of care that allow for aligning cost and quality information across payors.

For more information about the Transparency in Coverage proposed rule and the ACS’ comments, contact regulatory@facs.org.

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