Crit­ics say prices posted by hos­pi­tals too con­fus­ing

Chattanooga Times Free Press - - WORLD / NATION / POLITICS - BY ROBERT PEAR NEW YORK TIMES NEWS SER­VICE

WASH­ING­TON — 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.”

On Jan. 1, hos­pi­tals be­gan com­ply­ing with a Trump ad­min­is­tra­tion or­der to post list 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 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 per­cent of the con­sum­ing pub­lic, these data will be of lim­ited util­ity — mean­ing­less,” said Ken­neth E. Raske, pres­i­dent of the Greater New York Hos­pi­tal As­so­ci­a­tion.

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

The ad­min­is­tra­tion says it is open to sug­ges­tions for 2020 and be­yond.

Un­der prior guid­ance from the gov­ern­ment, hos­pi­tals could meet their obli­ga­tions by pro­vid­ing charges to pa­tients on re­quest. But the Trump ad­min­is­tra­tion wanted to go fur­ther.

“We’ve up­dated our guide­lines to specif­i­cally re­quire hos­pi­tals to post price in­for­ma­tion on the in­ter­net in a ma­chine-read­able for­mat,” Seema Verma, ad­min­is­tra­tor of the Cen­ters for Medi­care and Med­i­caid Ser­vices, said last week. “This is about em­pow­er­ing pa­tients.”

Martin Gaynor, a pro­fes­sor of eco­nomics and health pol­icy at Carnegie Mel­lon Univer­sity in Pitts­burgh, de­scribed list prices as “some­what fic­ti­tious.”

In its cur­rent form, he said, the price in­for­ma­tion is “not very use­ful and could even be mis­lead­ing” be­cause a hos­pi­tal with high list prices could be the cheaper al­ter­na­tive for some con­sumers, de­pend­ing on their in­sur­ance.

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