Hospital price lists: A small step toward price transparency

As part of the Affordable Care Act, hospitals are required to post their price list online. The federal law stipulated that hospitals had to post their price lists by Jan. 1, 2019.

Although the focus has been on how this will affect consumers, the price lists could affect the decision-making of doctors. If doctors are able to see the cost of some of the procedures using the price list, they could decide on a more affordable course of treatment.

Doctors can also use the price lists to decide where to send patients based on network and price. The tricky part is that if a patient has multiple symptoms, the doctor and patient won’t be able to use the price list to estimate the price of the visit because multiple tests could be needed.

The price lists are a step in the right direction, but there’s still a long way to go in price transparency.

The price lists are complex, with some listing prices with the procedure codes rather than the names of the actual procedures. And some procedures require multiple codes, making it difficult to figure out what the final cost of a procedure is.

Making it more complex for patients is that sometimes what they actually pay can be a lot less than the hospital’s listed price. For a patient with a health care plan, the out-of-pocket cost can depend on the deductible, copay and cost share. And health plans often negotiate their own price with hospitals, which can be lower than the price listed by the hospital.

Also, hospitals may give patients who don’t have a health care plan a discount.

According to an MLive.com story,* Grand Rapids-based Spectrum Health has posted average prices on its website for common tests and procedures since 2006.

We continue to employ new tools that make it possible for us to provide greater transparency and more precise estimates, Spectrum Health spokesman Bruce Rossman told MLive.com. We believe people need to be aware of health care prices and should ask hospitals and physician practices for pricing information.

Doctors and patients need to understand the cost of care, so they can plan for it sufficiently. Doing so helps people avoid situations where they’re surprised by costs and can’t financially plan for the care that they need.

Blue Cross and doctors share the same goal — to make sure patients have access to quality care that they can afford and obtain when they need it. Price transparency will help make that goal a reality.

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