According to a new federal law that came into effect on January 1, all hospitals are required to publish their price lists online for medical imaging and other services they provide. The new regulation proposed by CMS tends to improve transparency of medical treatments and services and allow patients to access their Electronic Health Records (EHRs), simple and fast.
Currently, under the Affordable Care Act (ACA), it is mandatory for hospitals to publish public price lists for all their services. However, the new regulation requires the prices to be available online in a downloadable format that the patients can easily access. Hospitals are also required to update the online prices annually. However, with the new rule, patients will still have to calculate their out-of-the-pocket costs as the listed prices online do not reflect what the insurers and government healthcare programs cover.
Is Posting Prices Online Helpful for the Patients?
As per the new regulation, all hospitals have started posting prices online. However, it seems, it may end up confusing the patients more than assisting them with their budget. In the name of offering price transparency, the medical center websites are now loaded with medical jargons, codes, dollar signs, and abbreviations that tend to “confuse more than illuminating.”
Anyone who has experience trying to find out how much a medical test, hospitalization or procedure will cost, knows the disappointment. “It depends” or “No, we can’t tell you” are common replies that come from medical centers and insurance companies. While the new regulation promises to bring more information and transparency into the system, it may fall short of providing valuable insights to the patients.
As stated by Julie Appleby and Barbara Feder Ostrov from Kaiser Health News and published on CNN edition, “That’s because the price lists displayed this week, called chargemasters, are massive compendiums of the prices set by each hospital for every service or drug a patient might encounter. To figure out what, for example, a trip to the emergency room might cost, a patient would have to locate and piece together the price for each component of their visit — the particular blood tests, the particular medicines dispensed, the facility fee and the physician’s charge, and more.”
Talking about the inconvenience that the new regulation will bring initially, Gerard Anderson, Director of the Johns Hopkins Center for Hospital Finance and Management said it would hardly be helpful for the patients. There are over 30,000 unique items filed on a chargemaster, and it would be difficult for a patient to know which ones are useful. Additionally, the online price posting system does not include how much insurance would cover and what the patient has to pay out of his pocket. Therefore, the information online is less likely to help them because only a few pay full charges.
A recent report published by Fox WRSP Illinois stated that it took “hours” of diligent analysis and assistance of hospital officials to identify and compare the cost of brain MRI between three hospitals. And this can be challenging for the patients. As said by Jay Roszhart, vice president of ambulatory networks and clinical integration at Memorial Medical Center, “The fact of the matter is it’s just not a very useful tool for people to understand what the price is.”
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