William W. Hurst
Law Office of William W. Hurst, LLC
50 S. Meridian St., Suite 600, Indianapolis, IN 46204
Before or after receiving visiting a hospital, do you wonder how much your treatment costs and what exactly the charges are for? In an attempt to create price transparency for patients, the Centers for Medicare & Medicaid Services (CMS) finalized a new rule. The new rule will, among other things, require hospitals to post their prices online and available to the public. The old CMS rule required hospitals to make public a list of their charges, but access to such information was difficult. When the new rule becomes effective January 1, 2019, hospital chargemasters will be posted online.
A chargemaster is a hospital list of prices for their services. CMS confirmed the new rule applies to all services and items provided by hospitals and does not exempt any hospital in the United States. The goal is to increase transparency that will allow patients to compare prices between hospitals and further understand their financial liability. However, because of insurance hospitals rarely charge their list price. The list price shows the cost of services when the hospital is out of a patient’s network. Insurance companies often negotiate with hospitals for a discounted price and the insurers will cover a large portion of costs associated with treatment. Patients will remain unaware of the actual cost of treatment unless their insurance company offers a price comparison tool.
Despite this new rule, barriers to price transparency still exist for consumers. Not all treatment can be anticipated, like an ambulance ride or a trip to the ER. Even with a planned surgery, additional issues may arise during the procedure. Further, unless you are familiar with medicine, reading the chargemaster list may be difficult and futile.
The cost of health care is continuously rising; however, maybe publicity of outrages costs will result in a decrease in prices. Some argue, a hospital’s list price may influence insurance companies to put the hospital in network in order to avoid surprise billing. A higher list price, more insurance companies will want to negotiate, which results in more patients. Whether or not this argument has merit, it is clear that CMS’s new rule will bring about some change for the benefit of patients and hopefully encourage greater price transparency.
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