Employer Plans May Be Impacted by New Executive Order on Health Care Price Transparency

Transparency, Quality and Cost Containment

President Trump issued an executive order on health care price transparency that instructs his administration to publish a number of proposed rules that would directly impact employer health care plans, including a requirement that self-insured employers “provide or facilitate access to information about expected out-of-pocket costs for items or services to patients before they receive care.”

Other provisions in the executive order which have drawn HR Policy support include requiring rules to:

• Expand the ability of employees to select high-deductible health plans that can be used with a health savings account to cover low-cost preventive care before the deductible for individuals with chronic conditions;
  
  
• Enable Health Saving Accounts, and potentially other arrangements, to be used for direct primary care costs;
  
  
• Increase the amount of flexible spending arrangement funds that can be carried over from year to year; and
  
  
• Increase access to de-identified claims data from taxpayer-funded health care programs and group health plans for researchers, innovators, providers, and entrepreneurs.

Other EO transparency provisions include rules to require hospitals to publicly post charge information and develop a "health quality roadmap" to align and improve reporting on data and quality measures across public health care programs.

Consistency with American Health Policy Institute studies: The EO advances ideas AHPI has written about, including in a recent paper, "ERISA Fiduciary Responsibilities for Health Care Plans," which notes that plan sponsors need the ability to obtain and use claims data in order to fulfill their fiduciary duties. You may also read AHPI's 2014 paper series on the importance of price transparency here: Part 1, Part 2, Part 3. 

Outlook:  Various agencies will have to develop and publish proposed rules and then receive and respond to public comments before finalizing the rules, a process that will take months, if not years.  The first proposed rules are not likely to be published until the end of this year, and many proposals won’t be ready until 2020.