Hospital Bill: Price Transparency Now in Effect

By Deborah Jeanne Sergeant

As of Jan. 1, health care providers have been required to post the price of their services online and make the prices available to anyone who asks.

Instead of receiving services and having to wait for the bill, patients can know what their visit, procedure or tests cost by going online, thanks to the Inpatient Prospective Payment System rule.

The movement toward transparency was largely patient-led, as more and more patients have become uninsured or have otherwise taken on more financial burden of paying for their health care through high deductible plans in the wake of the Affordable Care Act.

With social media and various quality measures related to different providers, patients can shop on the basis of patient satisfaction, along with price. In the past, patients tended to stick with one provider. Now that they bear more of the cost, they want to look around. Since the prices are readily available online, they can.

“It’s hightime competition came to the medical field,” said physician Joseph Barry who practices at Preventive Medicine Associates in Camillus. “Third-party payers have stifled competition. People should know the cost at doctor’s offices and hospitals.”

He compares the medical system to a grocery store shopper entering the store to purchase milk, but the costs depends upon how he chooses to pay for it.

“There are enormous forces still not played out,” Barry said. “For people with huge deductibles, they’re out shopping. As long as we have a third-party payer, we will have no real transparency.”

Since those payers negotiate for the price for services, they can pay different prices than those listed by providers. Barry hopes that greater transparency will lead to greater competition among providers and lower cost.

More options, such as independent surgery centers, concierge medicine and integrated medicine providers, have contributed to a health care culture of consumer choice. Price represents yet another factor.

Prices listed by any medical facility should be considered estimates, as the length of a hospital stay and complications can change it. Like a service writer’s estimate at a car repair garage, the estimates listed online can change.

Patients can also call the health system for an estimate. Most providers offer a payment plan and works with patients to find any grants available to help with costs, if needed.

“Trinity Health is committed to working with consumers, payers and policymakers on developing the best solutions for achieving price transparency goals,” said Jamie Arnold, communications officers with St. Joseph’s Health, which is a member of Trinity Health.

Arnold added that St. Joe’s has participation in the Centers for Medicare and Medicaid Services  and that rule-making process demonstrates the hospital’s “strong interest in public policies that support better health, better care and lower costs to ensure affordable, high quality, and people-centered care for all.”

Arnold said that patients can learn about the cost of procedures and the new policy by visiting www.sjhsyr.org/price-estimates.

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