Prices hard to come by in Mass. despite transparency law
Households may find medical bills absorb an increasing share of their income. But as consumers, their ability to shop among hospitals and clinics remains limited.
For more than a year, Massachusetts hospitals and clinics have been required to respond within two business days to consumers’ request for a price. That has proved difficult for some hospitals in the state surveyed by the public policy think tank Pioneer Institute. It surveyed 22 hospitals and 10 clinics on the price of a common and uncomplicated imaging service, an MRI without contrast.
Many hospitals could not quote a price within two days. Clinics fared much better. But both results did not shock national organizations that advocate for more price transparency.
“Generally, most states have very few laws that truly ensure that citizens have access to price information,” said Suzanne Delbanco, executive director of Catalyst for Payment Reform, which will release its third survey of state price transparency efforts this summer.
Massachusetts’ price law, one provision of the state’s broader 2012 statute to manage health spending, requires hospitals, clinics and health insurers to quote a price or estimate before patients receive care.
Hospitals struggle to do so for multiple reasons, said Delbanco and other transparency advocates. One procedure can combine bills from multiple sources: hospitals, doctors, laboratories and imaging centers. Among those with insurance, the amount patients will pay depends on rates negotiated by their insurance company and health plan deductibles or other out-of-pocket costs.
“Price is a nebulous thing in healthcare,” said Steve Wojcik, a vice president at the National Business Group on Health, which represents large employers.