More than a year later, some hospitals are still not complying with the Hospital Price Transparency Act

The Hospital Price Transparency Act requires hospitals to list cash prices for procedures on their websites so they are easily accessible and allow patients to compare cash prices with insurance.

In a study released this week, JAMA analyzed 5,000 hospitals nationwide and found that less than 6% were fully compliant.

Health economist at The Rand Corporation, Christopher Whaley, has examined how much employer costs have risen over the years and says knowing the true cost of healthcare will affect everyone.

“That’s actually money that the employer could spend on wages and other types of benefits and pay for healthcare instead,” Whaley said.

“We need the voice of the employer to say that this is important to us. We care about the quality of life and the affordability of life for our employees,” said Chris Skisak of the Houston Business Coalition on Health.

Here are some websites that can be used to assess hospital rates, according to the CBCH:

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Klara price

Health Sparq

turquoise health

The Leapfrog Group

“Make these types of transparency tools common,” Skisak said. “Once it’s common practice, we hope we can then have better negotiations about how we’re going to pay for healthcare.”

HCA healthcare

Turquoise Health finds HCA to be mostly in line with list prices in our area.

Here is the link they sent to KPRC: Pricing Transparency CMS Required File of Standard Charges | HCA Houston Healthcare

St Luke

St. Luke’s requires you to enter insurance to view insurance costs or select uninsured.

Here is the link to St. Luke’s Health Price Transparency page: Price Transparency

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Houston Methodist

“Houston Methodist is always transparent with patients about the cost of their treatment. A patient informs us of the insurance coverage they may have, and then we provide them with an estimate of the amount due prior to any elective services. We have published a shopping tool for more than 300 of the most popular services. You can find this information here. We are also working to make additional pricing information available to the public and expect to release it sometime this summer.”

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Herman monument

“Our comprehensive online pricing tool provides prospective patients with real-time, individualized cost estimates for planned procedures or services based on their specific circumstances. Insureds will be prompted to enter their insurance plan and policy number once they have selected their procedure or service and the facility they wish to visit. The calculator then provides the most accurate estimate possible of the cost of the procedure, the amount insurance will pay, and the amount the patient would be responsible for based on their specific insurance benefits, coverage limits, and co-payment requirements. For those who are not insured, the calculator offers the discounted self-pay rate. This tool goes beyond the mandatory disclosure of negotiated rates by providing user-friendly features and patient-specific information, thereby providing better access to the spirit of the rule as it was intended.”

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How does it help everyone to know the cost?

“The key takeaway is that if we don’t have information about prices, we can’t do anything about rising health care costs,” Whaley said.

What if I can’t find the prices I’m looking for?

The Department of Health and Human Services says hospitals can be billed as much as $5,500 a day for not reporting their rates. NBC News reports that hundreds of hospitals across the country have been warned for not doing so, but so far none have been fined.

The agency said it needs more people to report the hospitals that ignore price transparency.

You can submit this complaint here: CMS PT Complaint Intake Submission Form (qualtrics.com)

Copyright 2022 by KPRC Click2Houston – All rights reserved.

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