Why Hospitals Publishing Prices Is Just A 'Baby Step' Toward Transparency | Nashville Public Radio

Why Hospitals Publishing Prices Is Just A 'Baby Step' Toward Transparency

Dec 31, 2018

Patients will have a slightly easier time shopping around for care starting in 2019. U.S. hospitals will now be required to publish their price lists in a format that a computer could easily analyze.

Cost transparency advocates, like Bill Kampine of Nashville-based Healthcare Bluebook, say this is just a "baby step" toward consumers gaining some control over mounting hospital bills.

"I don't see really any functioning market where hidden prices serve the interest of the consumer or the customer," he says.

But Kampine notes that these prices are really only relevant to the uninsured. Every insurance plan negotiates its own discounted rate for a knee replacement, a c-section or any one of hundreds of services. And even that amount is not what a patient pays out of pocket.

"The bill charge will be of less value to consumers who actually have insurance," Kampine says. "It's a first step of providers becoming comfortable with this idea of publishing prices."

Kampine sees the next step as publishing average prices paid for hospital services. And the Centers for Medicare and Medicaid Services has foreshadowed plans to go further, making hospital billing more transparent.

"We have actively sought input on even more significant requirements," CMS administrator Seema Verma said in October.

Hospitals have resisted being more upfront about their charges, since the inflated rates could scare patients away from getting necessary care.

"We do not want patients to forgo needed care, especially if the quoted price is for the total cost of the service and not what the patient will be expected to pay out-of-pocket," American Hospital Association lobbyist Tom Nickels told Modern Healthcare.

But the largest hospital chains — most of which are based in Nashville — say they will be in compliance with the new federal rules, which will require updating their websites on New Years Day.