North Texas hospitals score all over the map for price transparency, according to an evaluation by Turquoise Health. The company found that Baylor Scott and White Health System and Methodist Health System hospitals were mostly transparent, while nearly every Texas Health hospital received the lowest rating possible. Medical City Healthcare facilities fell in the middle.
The evaluation tool allows consumers and professionals to search any hospital system in the country and see if it fulfills the federal Hospital Price Transparency Rule. The law requires hospitals to post clear, accessible pricing information online about the services they provide in a machine-readable file with all options and in a display of shoppable services in a consumer-friendly format.
Turquoise Health designs software to make price transparency clearer and works with consumers and providers to improve their adherence to the rules. The company’s Price Transparency Scorecard looks at sixty metrics to evaluate a hospital’s price transparency, giving each hospital a general score based on a 5-star rating. The rating is updated in real-time and allows hospitals to compare themselves to others while allowing consumers to see which hospitals have the most transparent pricing. Turquoise reviews around 6,000 hospitals nationwide every quarter.
If a hospital received four or more stars, Turquoise considers the hospital compliant, while two or three means some information is missing. One star means that there isn’t any data for that hospital. Beyond the star rating, Turquoise allows users to explore several different categories and data points to determine the score. “There’s a lot of complexity and nuance to what is in these files and how compliant one file is versus another,” says Marcus Dorstel, the head of operations at Turquoise Health. “That was the impetus for creating this much more comprehensive scorecard.”
In North Texas, nearly every Baylor Scott and White Health hospital system received five stars, as did most of the major hospitals for Methodist Health System. None of the Medical City hospitals received five stars, though most received four stars. Hospitals are required to post their negotiated rates with major insurance companies and cash pay prices, which are two of the places where Medical City hospitals lost points.
According to Turquoise Health, Texas Health Resources did not post a machine-readable file and did not have price transparency data available. Nearly all Texas Health facilities received just one star as a result. Texas Health has a price transparency page where patients can input their MyChart data or log in with insurer information to get a quote, but when I navigated the page, I could not choose a cash pay option or see a price without entering MyChart information or entering insurance information.
Parkland Health received one star, while JPS in Fort Worth received five. Cook Children’s Hospital and Texas Scottish Rite received five stars, but there wasn’t any data for either of the Children’s Health Hospitals in North Texas. Dorstel said that Children’s did not post a price transparency file, and though it did post a patient estimate tool, it didn’t comply with the legislation’s requirements.
Turquoise Health zoomed in on HCA Healthcare, Medical City’s parent company, as it is the largest health system in the country, with more than 200 hospitals and $40 billion in annual net patient revenue. The system was not compliant during the first half of 2021 but did publish its data in a machine-readable format later in the year. But a Turquoise Health blog describes HCA’s compliance as one that meets the letter if not the spirit of the law. “We’d equate this to being on the playground in elementary school and bragging to your friends that you’ve been kissed by a girl before. Technically, it’s true—you have been kissed by a girl before. But since that girl was your mother, it doesn’t really count,” it reads.
According to Turquoise Health, many large health systems were not compliant when the rule first went into effect, but by the end of 2021, no state was less than 30 percent compliant. Dorstel says that after Centers for Medicare and Medicaid Services’ announced that penalties would increase from $110,000 per year per hospital to $2 million, compliance jumped up. The legislation requires hospitals to update their data each year, which is also happening for the most part.
Consumers are taking notice of the increased transparency and shopping around. Dorstel says that people spend an average of 8.5 minutes on their website as they explore the prices for procedures and facilities. “That tells us that folks are coming on here and are clicking around shopping around,” he says. “They are probably looking at not just one service in one hospital, but maybe that same service across a couple of different hospitals.”
Looking ahead, Dorstel says the upcoming payer rule will be a game-changer. Many insurers already allow members to enter information to find the price of procedures at different facilities, but by July 1 of this year, payers will have to post a machine-readable file too. This will be a massive shift, revealing prices for hospitals that haven’t posted their data. It will also include pricing information for medical facilities other than hospitals. Patients will be able to see negotiated rates for imaging centers, labs, rehab centers, primary care practices, and more.
“That’s a big acceleration of price transparency across the US healthcare system,” Dorstel says. “We’ll see there’s just a ton more data coming out, including hospitals that haven’t posted by that point. When we’re talking to hospitals and health systems, we’re telling them this data is going to be public, one way or another. So you either post it yourself and control that narrative or wait until July 1.”
You can explore transparency and rates by hospital or procedure here.