U.S. hospitals post prices, but lists are confusing many Americans

Trump administration order was intended to increase transparency

Vanderbilt University Medical Center, responding to a new Trump administration order to begin posting all hospital prices, listed a charge of $42,569 for a cardiology procedure described as “HC PTC CLOS PAT DUCT ART.”

Baptist Health in Miami helpfully told consumers that an “Embolza Protect 5.5” would cost them $9,818 while a “Visceral selective angio rad” runs a mere $5,538.

On Jan. 1, hospitals began complying with a Trump administration order to post a list of prices for all their services, theoretically offering consumers transparency and choice and forcing health care providers into price competition. It’s turning into a fiasco. “This policy is a tiny step forward, but falls far short of what’s needed,” said Jeanne Pinder, founder and chief executive of Clear Health Costs, a consumer health research organization. “The posted prices are fanciful, inflated, difficult to decode and inconsistent, so it’s hard to see how an average person would find them useful.”

The data, posted online in spreadsheets for thousands of procedures, is incomprehensible and unusable by patients — a hodgepodge of numbers and technical medical terms, displayed in formats that vary from hospital to hospital. It is nearly impossible for consumers to compare prices for the same service at different hospitals because no two hospitals seem to describe services in the same way. Nor can consumers divine how much they will have to pay out of pocket.

“To 99 per cent of the consuming public, these data will be of limited utility — meaningless,” said Kenneth E. Raske, president of the Greater New York Hospital Association.

The list price for a hospital service is like the sticker price for a car. But as it is playing out, it is as if the car dealers were disclosing the price for each auto part, without revealing the charge for the vehicle as a whole.

The result has baffled consumers.

“This is gibberish, totally meaningless, a foreign language to me,” said Sara Stovall, 41, of Charlottesville, Va., after looking at price lists for hospitals in her area.

She reviewed the price lists for Sentara Martha Jefferson Hospital and for University Hospital, each of which has more than 16,000 items.

“I can’t imagine how I would go about making this useful,” Stovall said Sunday. “I wouldn’t know how to find my procedure. I wouldn’t know what services might be rolled up with my procedure. And I would not know the price to me after health insurance.”

By most accounts, the Trump administration is pursuing a worthy goal, but the execution of its plans leaves much to be desired.

After the administration proposed the price-disclosure requirement in April 2018, many hospitals warned of the shortcomings that are now evident.

But federal health officials, accustomed to debating issues inside the Washington policy bubble, have still been surprised at the reaction around the country as consumers and local news media try to decipher the data. The administra- tion says it is open to suggestions for 2020 and beyond.

The price-disclosure requirement, issued by the Department of Health and Human Services, grows out of one sentence in the Affordable Care Act, which says, “Each hospital operating within the United States shall for each year establish (and update) and make public (in accordance with guidelines developed by the secretary) a list of the hospital’s standard charges for items and services provided by the hospital.”

“For patients to know up front how much their care will cost, that’s incredibly valuable,” said Brenda L. Reetz, chief executive of Greene County General Hospital in rural southwest Indiana. “We’ve posted our prices, as required. But I really don’t think the information is what the consumer is actually wanting to see.”