With the new year came a federal mandate for hospitals across the country to release their chargemasters, or price lists, for all services offered at their facilities. What impact will this have on increasing price transparency for the average health care consumer? Will it help or hurt continued price transparency efforts?
How it May Help
- Having the “retail” cost of a procedure available may provided added incentive for employees to remain in network, where they can count on a more discounted rate.
- Requirement to publish this information can potentially enhance system wide transparency efforts and competition among providers.
On the Other Hand
- Hospital chargemasters may be hard to find and confusing to the average member, especially since the actual format of these lists has yet to be standardized.
- Without understanding their plan design, patients will not be better off with respect to out-of-pocket cost transparency and may even forgo needed care due to unfounded price concerns.
- Undiscounted price information isn’t likely to be useful or actionable for patients.
While hospitals are required to post their list prices in a “machine-readable format”, in practice this varies widely and often results in added confusion and difficulty in comparing prices for consumers.
Large and medium size employers, particularly those offering consumer directed health plans, have long offered price transparency tools designed to educate their members to become more informed health care consumers. Through these tools, as well as enhancing benefit offerings with advocacy and navigation services for their members, employers emphasize the importance of more conscious cost and quality decisions.
Results have been mixed: even with the breadth of tools and incentives available, a recent consumer study reveals 60% of consumers reported never having compared costs for recommended services to find the best value in 2018.
Actions Employers Can Take:
- Confirm that their vendor partners are prepared to answer member questions surrounding the difference between public chargemaster prices and the information available in employer-provided transparency tools
- Use the increased media exposure from this mandate as an opportunity to promote existing company resources and highlight how they provide more accurate and personalized information, while offering user friendly price comparisons among local providers.
Increased cost transparency is always a good thing. However, continued efforts to create standard and transparent quality metrics will likely make a bigger impact than releasing price lists directly to consumers that are unlikely to resemble their final bill.