Are hospitals posting their prices, as required?

Not much transparency.

Reposted from Just Care.

By Diane Archer

Beginning this year, hospitals are required to be transparent about the prices they charge different insurers for their services. But, Samantha Liss reports for HealthcareDive that hospitals are not being transparent about their negotiated prices. Why would they post their prices when the potential penalty is a mere $300 a day or a corrective action plan, a flick on the wrist?

As of January 1, all hospitals across the country must make their negotiated prices public, online. Until this year, virtually all hospitals claimed this information was proprietary, a business trade secret. There was no requirement for price transparency.

Hospitals that are complying with the transparency policy are burying information about their rates on their web sites or are not providing complete information. Researchers cannot find it. There is no single designated place for this information.

The Centers for Medicare and Medicaid Services (CMS) is overseeing this effort. But, CMS does not post the information. It is not even collecting it; hospitals are not required to send CMS the information. There is no simple way to know which hospitals are complying and which are not.

When the hospital price information is available, it is not likely to help individuals compare prices right now. Over time, if you’re shopping for insurance, you might be able to see which insurers are able to negotiate the best rates from the hospitals you want to use. Of course, that does not tell you whether the insurer has inappropriately high denial or mortality rates, two other factors that people should be able to consider when choosing a health plan but for which there is no information.

The hospital price information currently available reveals what we already know. The prices vary tremendously for the same service. According to Niall Brennan, head of the Health Care Cost Institute, one insurer might pay $5,000 for a C-section and another $55,000. Neither Congress nor president-elect Joe Biden is even talking about fixing this huge problem that drives up insurance premiums and out-of-pocket costs and jeopardizes access to care.

The American Hospital Association fought hard against hospital price transparency. But, it ultimately failed. A federal appeals court wouldn’t intervene to block the policy from going into effect. The American Hospital Association tried to say that some prices are unknowable. Really? Do the hospitals make them up as they go along?

5 thoughts on “Are hospitals posting their prices, as required?

  1. This is a sad and horrible consequence of having a social “good” completely privatized as a business. The big hand of the free market at work will only exacerbate the problems of an unfair and unjust health care system for most people. We need M4A….fast!

  2. A bunch of nearly decrepit old white men decide this stuff…for us…only because we are taught to let them?

  3. I suppose if one gets sick enough to have to go to a hospital, the first thing you’d think of is immediately calling all the hospitals within driving distance to find out how much they charge. Then you’d have to find out if the doctors involved in your procedure are in your network. Then you’d call your insurance company to find out how much the co-pay is. [Does the average person have any idea of what will be involved once you go to a hospital? At that point, nobody knows what is wrong. What kind of specialist do you need? You’d have to be a self-analyzing doctor before you call to inquire about the cost.]

    This is a disgusting system which is meant to make money for hospitals and doctors. Nobody does all of that if they are sick. SO, never get sick.

    When I was in Kuala Lumpur, Malaysia I had an hour long operation on my R foot big toe. I stayed four days and the doctor would have let me stay longer if I had wanted to. It cost me nothing.

    I had operations on both of my knees. That and the therapy for months cost me nothing.

    1. I agree with you, but the Doctors aren’t the problem. They have to “game” the insurance system to make money so that they can pay office staff and incredibly high malpractice insurance while paying off student debt from medical school. The only way that doctors can make money is by having multi Dr practices so that costs can be shared….which isn’t really good for patient care. Dr.s and RNs were sounding the alarm way back in the 1990’s about how this would play out.

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