N.C. re­quires post­ing of prices

Modern Healthcare - - LATE NEWS - Andis Robeznieks

Anew law in North Carolina marks a ma­jor ad­vance in the move­ment to make health­care prices more trans­par­ent for con­sumers. It arises from grow­ing pres­sure on law­mak­ers and health­care providers to give the pub­lic ac­cess to price in­for­ma­tion en­abling pa­tients to more ef­fec­tively shop for care, thus en­cour­ag­ing price com­pe­ti­tion.

Repub­li­can Gov. Pat McCrory signed leg­is­la­tion that will re­quire his state’s hos­pi­tals and am­bu­la­tory surgery cen­ters to dis­close what they’re paid for 140 med­i­cal pro­ce­dures and ser­vices. The prices for 100 com­mon in­pa­tient ser­vices, 20 sur­gi­cal pro­ce­dures and 20 imag­ing pro­ce­dures will be posted on the state Depart­ment of Health and Hu­man Ser­vices web­site. The leg­is­la­tion also lim­its hos­pi­tals’ abil­ity to put liens on pa­tients’ homes and for­bids state-owned hos­pi­tals from gar­nish­ing pa­tients’ wages to re­coup debts.

“North Carolina sets a new bar in terms of what type of in­for­ma­tion they re­quire,” said Richard Cauchi, di­rec­tor of the National Con­fer­ence of State Leg­is­la­tures’ health pro­gram. Cauchi said that while 10 states have es­tab­lished “all-payer claims data­bases,” those data­bases are not in­tended for con­sumer use.

Ear­lier this year, the CMS pub­lished data dis­clos­ing what hos­pi­tals charge and what Medi­care pays them for com­mon in­pa­tient and out­pa­tient pro­ce­dures. De­spite provider com­plaints, the Obama ad­min­is­tra­tion said the dis­clo­sures were a step to­ward help­ing con­sumers make more in­formed health­care de­ci­sions.

The new North Carolina law will shine a light on the ac­tual prices paid by Medi­care and Med­i­caid and billed to the unin­sured, as well as the aver­age and range of prices paid by the top five in­sur­ers.

“For too long, North Carolina pa­tients have been in the dark on what they can ex­pect to pay for com­mon med­i­cal pro­ce­dures when they are ad­mit­ted to a hos­pi­tal,” McCrory said in a news re­lease.

North Carolina At­tor­ney Gen­eral Roy Cooper, a Demo­crat, praised the law for help­ing “peo­ple who are strug­gling with in­com­pre­hen­si­ble med­i­cal bills and un­rea­son­able col­lec­tion prac­tices” and for re­quir­ing fa­cil­i­ties to post their char­ity and fi­nan­cial as­sis­tance po­lices. “We rec­om­mend that con­sumers shop around for a good deal, but our health­care sys­tem doesn’t make that easy to do,” he said.

The North Carolina Hos­pi­tal As­so­ci­a­tion was less en­thu­si­as­tic. “Hos­pi­tals have been mov­ing in this di­rec­tion for some time now,” NCHA spokesman Don Dal­ton said. “We also de­sire to see lower health­care costs. Un­for­tu­nately, as long as the state con­tin­ues to pay hos­pi­tals less than our costs of car­ing for Med­i­caid pa­tients … and does noth­ing to ad­dress those who have no in­sur­ance, costs will con­tinue to rise.”

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