Shift Shapers Podcast

23 Mar 2020

Ep #305 Part 2: Reading the Regulatory Tea Leaves – with Jessica Waltman

David Saltzman 0 Comments

This is part 2 of The ShiftShapers Podcast episode called “Reading the Regulatory Tea Leaves – with Jessica Waltman” and today, host and Chief Transformation Strategist David Saltzman and Jessica discuss transparency changes on the regulatory front and how these changes can affect you and your clients.

In particular, Jessica breaks down into plain language the transparency rules that affect hospitals and the differences with the rules for insurers and employer-sponsors in disclosing information. Jessica also explains how the new rules affect regular consumers and how requests for information can be made.

What You’ll Learn From this Episode:

  • 02:17 Transparency rules: 1 enforced & 1 pending
  • 04:49 Hospitals to make their rates public: online & list of common services
  • 09:00 Transparency for insurers, employer-sponsors & plans
  • 13:42 Ceding liabilities

Quotes:

04:02 “The hospitals have sued the Trump administration over this rule and they are trying to stop it from being implemented.”

05:27 “It’s really looking at what’s the hospital take-home for these services. It’s not really looking at what you or I might pay if we went into the hospital.”

09:12 “What the employers and the insurers are going to be asked to do is they have to disclose the price to consumers. They have to make it available.”

13:42 “If you’re a fully-insured regular small group of 20, you have liability but you can cede your liability to your carrier via your contract.”

14:28 “In a self-funded scenario, the ultimate liability for this getting done as proposed rests on the employer-sponsored plan.”

Listen to the Full Interview:

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