A federal law that requires hospitals to post their prices went into effect yesterday, moving toward the transparency that consumers are likely to say they desire. But the complicated system of who pays for healthcare may lead to more confusion.
The new law requires hospitals to post their price for standard charges, but because insurance companies negotiate with providers on the price they will pay for an operation, many say the “price” that is posted will be meaningless. In addition, each consumer’s insurance plan will impact what the person actually pays for a procedure. In addition, patient health can cause complications that impact the cost of the procedure. So the posted price might not have much of a connection to what the average person pays, once insurance, complications, and patient health is considered, somewhat defeating the purpose of posting the price. But it is a starting point.
In a statement, Baylor Scott and White expressed skepticism to D CEO Healthcare in June. ““We believe that pricing transparency needs to be meaningful to patients and are concerned whether CMS’ proposed guidelines meet this objective,” the statement read. “CMS proposes that hospitals make public a list of hospital charges. This approach is not a comprehensive solution and will likely lead to greater confusion for patients seeking information about actual out-of-pocket costs.”
Today, Baylor notes that the complicated process of determining the actual price for consumers. They wrote in a statement:
“Baylor Scott & White Health supports the vision of greater pricing transparency for patients and recognizes the importance of sharing anticipated out-of-pocket costs with patients prior to service.
We believe that pricing transparency needs to be meaningful for patients seeking information about actual out-of-pocket costs, and our organization has made significant investments over the past five years to implement technology and processes to help patients get the information they need to make decisions about their care.
On the “Estimate Your Cost of Care” page on BSWHealth.com, an automated price estimation tool is a reliable source for specific estimates of out-of-pocket costs because it combines our pricing (charges), contract terms and rates, and real-time eligibility and benefit information to produce a unique estimate for each patient. It is on this webpage that we are posting the list of standard charges mandated by the Centers for Medicare & Medicaid Services (CMS).
Our pre-registration team makes proactive phone calls for patients with a scheduled service to provide them with an estimate in advance of service, and our price estimate team provides price shoppers with the opportunity to call, email or chat with us online to obtain an estimate for potential services at one of our locations.”
Cook Children echoed the doubts about posting the prices to NDCDFW. “Cook Children’s is dedicated to publicly providing standard charges for treatment so patients and parents can make the best medical decisions for their family. However, sharing meaningful information is challenging because pediatric care is specifically tailored to the needs of each child.”
Texas Health described the complications to NBCDFW as well. “Patients should be aware that the exact cost of their care will be dependent on many factors, including their specific set of procedures, their insurance coverage, and the amount of their deductible that has already been met prior to the new procedure.”
Look for more coverage soon about how each of these hospitals are actually posting the prices online.