N.C. requires posting of prices
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.”