Even With More Transparency, Hospitals Still Charge Wildly Different Amounts For The Same Procedure

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Michigan's hospitals are not too different from hospitals across the nation, Fisher said.

The PRA survey found only two of eight hospitals in Michigan were fully compliant: Munson Medical Center and Michigan Medicine, the University of Michigan's health system.

The six noncompliant Michigan hospital operators were Ascension Providence Hospital Southfield, Beaumont Hospital-Royal Oak, Beaumont Hospital Troy, Henry Ford Hospital in Detroit, Spectrum Health Butterworth Hospital, and St. Joseph Mercy Ann Arbor.

Crain's contacted the hospitals and most said they are now compliant with the rules.

Fisher said some of the hospitals had only minor omissions. "They are primarily not presenting all of the data fields. Most of them might not have shown the discounted cash prices as well as the negotiated rate by every payer," she said.

Kevin O'Neill, vice president of contracting for Henry Ford Health System, confirmed Henry Ford was one of six hospitals cited by Patient Rights for not fully complying with the price rules. He said the system inadvertently left out several data points from the charge information. Click here for the price estimator.

"There's hundreds of thousands of data fields. We were required to publish the minimum, maximum and median of (charge information by payer). We were missing the minimum. It was an oversight and we fixed it," he said.

Mark Geary, spokesperson for Beaumont Health, said Beaumont believes "it meets and even exceeds the 2020 CMS standards." Click here for the price estimator.

"Based on the (Patient Rights Advocate) report provided, being marked as noncompliant due to the zeros in the files does not mean information is missing and/or incomplete," Geary said, adding: "We do use the price estimation tool which CMS clearly approved in lieu of posting 300 shoppable services."

Ascension said it is fully compliant with the price transparency rules and has expanded its hospital websites beyond what is required by the law, said spokesperson Chris Gleason. She said the system's price estimator tool includes more than the required 300 shoppable services.

"Ascension takes the information shared by the Patient Rights Advocate organization seriously and our price transparency team is working diligently to confirm that we meet all standards outlined by the Affordable Care Act," Gleason said in an email.

Trinity Health Michigan, which operates eight hospitals in Michigan, said it believes it is fully compliant with the rule with regard to patients as it has more than 300 shoppable services available with its self-pay price estimator tool, said David Bittner, the system's chief revenue officer.

Bittner said Trinity is in the process of completing discounted cash price service for its machine readable database. He said there has been a slight increase in people accessing the database.

"The complete standard charge file is there," said Bittner, adding: "Our goal is to have all services available with the estimation tool ... across all 55 hospitals in 22 states."

Spectrum said it believes it is full compliance with the rule and has been posting prices on its website since 2006, said spokesperson Ellen Bristol.

"Spectrum Health is a strong proponent of transparency and sharing hospital prices," Bristol said in an email. "Transparency in healthcare is important. We feel employers and consumers need to be aware of healthcare charges and should not hesitate to ask hospitals and physicians for pricing information."

The Michigan Health and Hospital Association said its member hospitals are helping patients understand their healthcare costs. The COVID-19 pandemic slowed implementation, the MHA said.

"In addition, there is ambiguity within the final rule that has left hospitals to interpret the level and detail of pricing information that should be provided to consumers," MHA said. "Hospitals and health systems are working diligently to comply with federal policies in their release of information."

Source : https://www.modernhealthcare.com/hospitals/price-cost-procedures-providers-transparency

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