How Much Does It Cost? Addressing Price Transparency
// By Althea Fung //
Health care is in the midst of a shift toward a consumer-centric model — empowering patients to have a greater role in how their health care dollars are spent. But there’s a problem. It’s hard to shop around if no one can tell you how much services cost.
A 2017 price transparency study published in the journal Hospital Pediatrics found 30 out of 45 pediatric hospitals contacted provided price estimates. Only 12 of the 30 that provided estimates had online price calculators.
A new price transparency guideline from the Centers for Medicare and Medicaid Services (CMS), which went into effect in January, is aimed at addressing the opaque nature of health care pricing. Hospitals are now required to publish a standard list of prices online in a machine-readable format for patients. University of Utah Health, a four-hospital, Salt Lake City-based system, took the requirement a step farther and implemented a comprehensive cost estimator tool for about 500 common services and procedures, giving a single price that includes the full scope of costs.
“A few years ago, our senior leaders asked the question, ‘How would we respond if asked to publish our prices online?’ We formed a system-wide team consisting of hospital billing, physician billing, marketing, and clinical leaders to answer that question,” says Kathy Delis, administrative director of revenue cycle support at University of Utah Health. “We started going down the path of looking into how we can provide that information for both our existing patients and also consumers who are just shopping.”
In 2016, three years before the guidelines went into effect, University of Utah Health began posting the out-of-pocket expenses on its website. “I’m thankful we went down this path; we don’t just publish our CDM (charge description master), we have a tool that provides a meaningful estimate,” she says.