Healthcare News & Insights

Who’s exposing your prices now?

There’s yet another resource patients can use to research your facility’s pricing information without your input. 

461892409The healthcare industry has seen a strong push for transparency from patients and regulators in recent years, particularly in regards to procedure and treatment prices and provider reimbursement.

However, hospitals generally are reluctant to release this kind of financial information to the public.

As a result, federal agencies, like the Centers for medicare & Medicaid Services (CMS), and third-party organizations are taking it upon themselves to give the public the price data they demand.

The next price database

The Health Care Cost Institute (HCCI) is the latest organization to compile a price database, according to Modern Healthcare.

The group recently launched its new website, Guroo, for comparing the cost of 70 different medical procedures, in more than 300 cities, 41 states and Washington DC.

HCCI compiled the databases by comparing claims for more than 40 million people submitted by big-name insurers, like Aetna, Assurant Health, Humana and UnitedHealth.

David Newman, HCCI’s executive director, said the website is meant to give patients a comprehensive view of cost on “shoppable, discretionary, scheduled services.” This way patients can see the average market cost of treating a condition, including the office visits, lab and diagnostic tests, procedure and other services associated with a treatment.

The database will soon include pharmaceutical prices, too. And later this year, HCCI will launch another website focused specifically on giving information about out-of-pocket costs for services.

Unfortunately, though Guroo could give consumers good estimates of the cost of care, there’s a risk patients might take the website information as law.

As Newman put it, the website prices are accurate “assuming that the patient, on average, is average.” However, as most physicians know, healthcare treatment can be very subjective. That means prices could still vary depending on certain factors, leading to sticker shock for patients who may not consider this point when shopping around.

Another CMS report

In addition to third-party organizations compiling price information, many states have also compiled payor databases in an attempt to make providers more accountable for the prices they charge.

Additionally, as The Wall Street Journal reports, CMS announced that it would release a yearly report on how much Medicare providers were paid for services.

CMS released a similar report last year, which received criticism for leaving out important information to contextualize the price data, leading to negative misinterpretations by the media and public.

Straight from the horse’s mouth

Generally, research has shown patients are more likely to go to other sources because it often can be difficult to acquire pricing information from their hospitals. So as patients continue to be sensitive to the cost of their care, they’ll also continue to seek out information from others, regardless of how accurate those sources may be.

The best way for hospitals to avoid misunderstandings based on these incomplete pictures of prices, is to give patients the information they want directly.

Hospital leaders can conduct drills like “secret shopper” calls to their facilties, and other tests to gauge how easily patients can acquire information and plan accordingly.

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