Community Howard Regional Health and St. Vincent Kokomo have both published their once-secret master price lists following a federal mandate requiring every hospital in the country to publish online the starting price tag for every service and item.
The mandate took effect Jan. 1 after the Centers for Medicare & Medicaid Services (CMS) in August issued the rule in an attempt to encourage price transparency by improving public access to charging information.
Previous law required hospitals to make a public list of their standard charges. The new mandate requires those lists to be published online.
Now, the master price lists, also known as chargemasters, provide an exhaustive look at what both local hospitals in Kokomo consider their base price.
Consumers can find the starting rate of thousands of procedures, pills and other items ranging from a knee surgery starting at $2,025 at St. Vincent to a low-dose aspirin starting at 82 cents at Community Howard.
But Dixie Platt, vice president of communications and federal relations for the Indiana Hospital Association, said the data may not provide an accurate guide for consumers to determine what they can actually expect to pay at the hospitals.
That’s because the cost of services will change once the hospital negotiates with a patient’s insurance company, she said. Also, one procedure, such as a hip replacement, may include dozens of items or other services that aren’t included in the base price of the procedure.
“I see this as a good way to have more information out there on pricing, but I don’t think it’s what people will be looking for or find helpful,” Platt said. “It’s very difficult to piece together what an actual procedure would cost. Even if you could do that, it’s probably not the price people would pay, because it won’t reflect the price hospitals negotiate with insurance companies.”
She said a more useful tool to provide a realistic estimate on what medical procedures would actually cost can be found at www.mycareinsight.org, which allows people to search the prices – and quality – of hundreds of the most common services at hospitals across the state.
Even with the new mandate, CMS said it is still concerned about healthcare costs. The agency said challenges will continue to exist for patients due to insufficient price transparency, including patients being surprised by out-of-network bills for physicians who provide services at in-network hospitals.
Consumers are also still frequently surprised by facility fees and physician fees for emergency room visits, CMS said on its website.
But with the new mandate, the agency says it hopes to “empower patients through better access to hospital price information, improve the use of electronic health records, and make it easier for providers to spend time with their patients.”