Idea 5 of 11 · working draft
Send One Hospital Bill and Make Insurance Easier to Compare
For care a hospital arranges, you would get one bill instead of bills from each doctor or lab.
After a hospital procedure, patients can get separate bills from the hospital, the anesthesiologist, the lab, and others. This plan would send one bill from the hospital. The hospital would then pay the others. It would also make insurance plans easier to compare. Require nonprofit hospitals to publish how much free and discounted care they give and how they use their tax exemption.
What it would do
- Send one hospital bill and have the hospital pay the other providers.
- Use standard insurance plans, billing codes, and clear payment schedules.
- Require a provider to accept a plan at all its locations.
- Require nonprofit hospitals to publish how much free and discounted care they give and how they use their tax exemption.
One bill
For a procedure the hospital coordinates, the patient gets one bill from the hospital. The hospital pays the anesthesiologists, labs, imaging providers, and others. The patient does not have to sort out separate bills and networks.
Make insurance easier to compare
- Offer a limited set of standard plan designs, so benefits can be compared side by side.
- Use common billing codes so insurers cannot win by making claims harder to understand.
- Use clear, set payment schedules to reduce the power that comes from hospital mergers.
- A provider would accept a plan across all of its locations, not pick and choose networks.
Accountability for nonprofit hospitals
Require nonprofit hospitals to publish how much free and discounted care they give and how they use their tax exemption. Federal law would set measurable standards for charity care and community benefit, require clear reporting of executive pay, and put tax-exempt status at risk after repeated failure.
The hard questions
Standard plans can limit new ideas. Some doctors might leave insurance networks and take only cash. Any final law would also need strong risk adjustment. That means plans cannot profit by attracting healthy patients and avoiding people with greater medical needs.
Sources and background
CMS explains protections against surprise medical bills under the No Surprises Act. Those protections are background, not the draft’s proposed single hospital bill, standard insurance designs, or payment schedules.
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Common questions
- What is the “Send One Hospital Bill and Make Insurance Easier to Compare” idea?
- For care a hospital arranges, you would get one bill instead of bills from each doctor or lab.
- How would it work?
- After a hospital procedure, patients can get separate bills from the hospital, the anesthesiologist, the lab, and others. This plan would send one bill from the hospital. The hospital would then pay the others. It would also make insurance plans easier to compare. Require nonprofit hospitals to publish how much free and discounted care they give and how they use their tax exemption.
- One bill?
- For a procedure the hospital coordinates, the patient gets one bill from the hospital. The hospital pays the anesthesiologists, labs, imaging providers, and others. The patient does not have to sort out separate bills and networks.
- Make insurance easier to compare?
- Offer a limited set of standard plan designs, so benefits can be compared side by side. Use common billing codes so insurers cannot win by making claims harder to understand. Use clear, set payment schedules to reduce the power that comes from hospital mergers. A provider would accept a plan across all of its locations, not pick and choose networks.
- Accountability for nonprofit hospitals?
- Require nonprofit hospitals to publish how much free and discounted care they give and how they use their tax exemption. Federal law would set measurable standards for charity care and community benefit, require clear reporting of executive pay, and put tax-exempt status at risk after repeated failure.
- The hard questions?
- Standard plans can limit new ideas. Some doctors might leave insurance networks and take only cash. Any final law would also need strong risk adjustment. That means plans cannot profit by attracting healthy patients and avoiding people with greater medical needs.
- Sources and background?
- CMS explains protections against surprise medical bills under the No Surprises Act. Those protections are background, not the draft’s proposed single hospital bill, standard insurance designs, or payment schedules.
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