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The pincer movement of cost and quality in neurointerventional care: resource management as an imperative
  1. Joshua A Hirsch
  1. Correspondence to Dr Joshua A Hirsch, Interventional Neuroradiology, Massachusetts General Hospital, Boston, MA 02114, USA; hirsch{at}

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On August 2, 2018, the Centers for Medicare and Medicaid Services (CMS) issued a final rule (CMS-1694-P) that they hoped would provide patients and caregivers better access to hospital pricing information with the goal of achieving greater price transparency in the provision of healthcare.1 As of January 1, 2019, hospitals will be required to “make available a list of their current standard charges via the Internet in a machine readable format and to update this information at least annually, or more often as appropriate. This could be in the form of the chargemaster itself or another form of the hospital’s choice, as long as the information is in a machine readable format". CMS believes that this will promote price transparency by improving public access to hospital charge information.

In language from the same final rule, there is tacit acknowledgment of the many comments CMS received that were clearly concerned about this change. They (CMS) indicate an awareness of the challenges that continue to exist because, for example, the chargemaster data may not accurately reflect what any given individual is likely to pay for a particular service or visit. Additionally, the comments argue that the chargemaster data would not be useful to patients because it is confusing as to the amount of the actual out of pocket costs imposed on an individual patient. CMS insist that they are considering ways to further improve the accessibility and usability of the information disclosed by the hospitals.

Cloaked in the simplicity of this disclosure request are various complex issues. As a result, CMS issued a frequently asked question (FAQ) sheet in late September 2018. In this FAQ sheet, CMS clarified that the requirement for transparency applied to all items and services provided by the hospital. CMS further encouraged hospitals to undertake efforts to engage in consumer friendly …

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  • Competing interests JAH is supported by Research Grants from the Harvey L. Neiman Health Policy Institute while serving as Chair of the SNIS Health Policy and Economics Committee.

  • Provenance and peer review Commissioned; externally peer reviewed.

  • Patient consent for publication Not required.