January 16, 2019
Writer: Jessica Morgenthaler
In efforts to help patients be more aware of their treatment prices, the federal government issued a new rule requiring hospitals to publish the prices of treatments offered at their hospital.
The Centers for Medicare & Medicaid Services put this rule into effect Jan. 1 and it is already raising concerns from hospital administration.
“I think that’s where the confusion comes when people look at the different cost for hospitals and things like that,” said Doug McBride, the executive director for business development of Madison Memorial Hospital, “Yeah, they can kind of compare between hospital to hospital but there’s a lot of things that go into the moving parts of that of what you’re actually going to be out of pocket for you to have to pay... it’s okay to have those prices up there but I just don’t want them to be so confusing that people don’t realize what they’re doing.”
With increasing health care prices, CMS hopes this will help patients and caregivers be able to compare prices to other hospitals and make decisions to stay within budget.
In a news conference call held by CMS, administrator Seema Verma explained the reason for this rule.
"Studies have shown upwards of 44 percent of Americans say they may skip a doctor’s visit when sick due to the impact of cost on their budget,” she said. “While 40 percent have forgone routine preventative care all together. Similar percentages say they fear the cost associated with a serious illness more than the number that say they fear the illness itself.”
Verma mentioned that some health care facilities are already addressing these concerns to go further in helping their patient understand the costs.
McBride suggested for those seeking care at Madison Memorial, that beneficiaries get a code, or bill item ID from their physician. Then use that code to search for the correct procedure under their list of offered care prices.
There are other factors that can affect billing, including insurance and procedure changes or complications.
This rule is just the first step in CMS efforts to make hospital pricing more transparent and budgeting easier for consumers.