Hospital price transparency is clear as mud
Our VP of Product, Matt Parker, recently published this article in MedCity Influencers. Below is only an excerpt, you can read the full article here.
You may have heard the news that hospitals are now required to post prices in a way that is easy for patients to find. There’s been a fair amount of media coverage championing these hospital price transparency requirements from CMS that went into effect on Jan. 1. This milestone regulation is in support of patients and reducing healthcare costs. Even Susan Sarandon has signed on as a spokesperson to make sure people are aware that it’s now their right to know hospital service pricing. The mandate requires that certain hospitals must post machine-readable files of pricing for all items and services, as well as a display of at least 300 “shoppable” services in a consumer-friendly format.
Despite the media coverage, just one in 10 adults (nine percent) are aware that hospitals must disclose the prices of treatments and procedures on their websites, according to KFF Health Track. But it doesn’t matter much since research revealed that 86 of 100 randomly selected hospitals were not fully-compliant. Hospitals claim challenges they have in building and supporting this online data and say they are concerned about sharing negotiated rates publicly.
While the mandate has the right intent, it misses the mark.
The ugly truth about transparency
Healthcare doesn’t work like other consumer goods and services – payment models are messy and complicated. Regulations at the state and federal level are helping shine the light on care costs and providing new consumer protections, but posting JSON files online or ‘rack rate’ hospital costs at each organization’s website doesn’t help people. In addition, a recent survey shows most people don’t go to hospital websites looking for care costs, they go to their health plan. And even when they do, they are challenged when using hospital price transparency sites to access information and understand price variation. About 87.5% of people have some kind of health insurance and they need to understand their personal liability for planned services based on that coverage.