PPH - Official PPH Blog

Transparency plan; Medicare Advantage 2020

The Trump administration has just signed in an executive order that requires hospitals to disclose their consumers the prices they charge the insurers. Medicare advantage, one of the variations of the medicare health insurance program are provided by private health insurance companies would certainly be affected. Part D of the medicare advantage that provides administered drugs is also administered by private insurances companies.

Medicare itself a federal health insurance program for people who are sixty-five and older, or someone who has not to fall into the sixty-five-year bracket, however, has disabilities.

Medicare comes in three parts;

1.     Part A covers hospital care

2.     Part B covers doctors, medical test, and procedures. This is a basic package that they offer, however, there is a premium program for it.

3.     Part D is administered by private insurances companies, and it required to be taken unless there is an alternative coverage from another source.

The reason why the Trump administration has signed in this bill is to lower the cost. This bill, however, would only serve its function for health care services that are shoppable such as elective surgery when people have the time to compare prices. Other times when they were in emergency situations, they would barely think about comparing the price of options that they had.

The bill would require hospitals to publicly post standard charge information in a way that would meaningfully inform patients decision making and allow patients to compare prices across hospitals.

President Trump stated that he hopes that by making meaningful prices and qualify information more broadly available, Americans will protect patients and increase competition, innovation and value in the health care system. This is also done to increase the transparency of their American health care system. The price hospitals charge the insurers rarely reflect what patients really pay. Medicare advantage 2020 can sure help.

Some of the patients have cheered on the prospect of being able to compare the prices of each hospital. However, analysts think that the plan could backfire. For a simple reason that hospitals set prices by negotiating with individual insurance companies in a process that is kept confidential. If hospitals are forced to publish the rates, every health administrator would suddenly know what other insurers are paying. They could use that information to bargain for lower rates. However, if the hospitals are forced to lower rates, it is feared that it would come to another way being a scapegoat of them lowering the rates. There could be a chance that the price would go up for everyone.


The government is finding innovative solutions to improve the beneficiaries. However, as a beneficiary, it is important to not choose an insurance company based on the amount of premium, but also other factors such as the wide of a network of hospital and doctors that the beneficiary can enroll with. Overall, the amount paid has to reflect the number of facilities that most suitable for the beneficiaries to use.