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AAOS Sends Letter on Price Transparency

On March 23, AAOS sent a letter regarding price transparency to U.S. Senators Bill Cassidy, M.D. (R-LA), Michael Bennet (D-CO), Chuck Grassley (R-IA), Tom Carper (D-DE), Todd Young (R-IN), and Claire McCaskill (D-MO), who are seeking feedback from the health care and patient communities as they develop legislation to improve price transparency in the health care market and lower costs.

“Real world experience and evidence-based policies from health care stakeholders and experts will be important to craft a policy that most positively affects consumers and involves best practices from providers and states,” the bipartisan group wrote to stakeholders. “We all agree that health care costs are too high and now is time to move towards a system that is more open, efficient, and accountable to the needs of the modern patient.”

The AAOS response focused on a number of issues, including assessing quality, all payor claims databases, “big data,” and site neutrality.

“Traditionally, Medicare uses different payment systems depending on the location where a beneficiary receives services (e.g., inpatient, outpatient, Ambulatory Surgical Center (ASC), emergency department, physician office),” the AAOS letter states. “However, significant variation is all too common in the Medicare payment system and has resulted in inefficient care and increased costs to Medicare patients who face higher co-pays for hospital outpatient services compared to services provided in an office setting… Expanding the site-neutral payment policy – and, in particular, equalizing rates for office visits and in-office procedures as well as ASC procedures – will allow patients to receive the same care for the same out-of-pocket cost, regardless of the facility site. This will also do away with various Medicare reimbursement complexities surrounding inpatient versus outpatient/observation status for patients, thereby reducing burden for both providers and patients.”

Read the full letter online here.