Study looks at cost of care
Demands for transparency driving change
There’s been much written in the past year about just how hard it is to get a simple price for a basic health care procedure. The industry has heard the rumblings, and now it’s responding.
About two dozen industry stakeholders, including lobbying groups for hospitals and health insurers, issued recommendations Wednesday on how to provide patients more information about the cost of health care services.
The focus on health care price transparency has intensified as employers shift more costs onto workers, and many new health plans under the Affordable Care Act feature high out-of-pocket costs.
The health care industry has some catching up to do on the transparency front. States have passed their own price-transparency laws, Medicare has started to release data on the cost of services and what doctors get paid, and private firms have developed their own transparency tools.
“We need to own this as an industry. We need to step up,” said Joseph Fifer, president and chief executive of the Healthcare Financial Management Association, which coordinated the group that developed the recommendations.
The stakeholder group includes hospitals, consumer advocates, doctors and health systems.
Their recommendations delineate who in the health care system should be responsible for providing pricing information and what kind of information to provide depending on a person’s insurance status.
The report’s major recommendations include how to provide patients with the total estimated price of the service; a clear indication of whether the provider is in-network or where to find an in-network provider; a patient’s out- of-pocket costs; and other relevant information such as patient-safety scores and clinical outcomes.
The group also recommended that health care providers offer uninsured patients the estimated cost for a standard procedure and make clear how complications could increase the price.
That appears easy. But previous research points out just how difficult it can be to determine the price of even a basic, uncomplicated procedure. In a JAMA Internal Medicine study published in December, researchers found that just three out of 20 hospitals could say how much an uninsured person should expect to pay for a simple test measuring their heart rate. J.R. Curley uses his Google Glass at the Manhattan Beach Pier, Calif. For all the controversy Glass has generated for its ability to take pictures with simple gesture or voice command, Curley says the attention it gets on the streets of Los Angeles has been positive.