Hospital price research is 'frustrating' for consumers, report says

Hospital price research is ‘frustrating’ for consumers, report says

Finding prices for healthcare procedures on Massachusetts hospital websites can be a “backdoor or frustrating process,” according to a new report, despite a 2019 federal law requiring hospitals to make all prices available online in a user-friendly format.

The Pioneer Institute studied a sample of 19 Massachusetts hospitals to assess compliance with the Public Health Services Act, which went into effect in January 2021 following the adoption of regulations by the federal Centers for Services Medicare and Medicaid. The researchers said the hospitals surveyed were “of all sizes in urban, suburban and rural areas of the state.”

In addition to finding “wide price variations for several common procedures,” the researchers determined that information on discounted cash prices – the rate a hospital would charge people who pay cash – was not available for 37% of hospitals in the study.

“Even among hospitals that display discounted cash prices, there are varying rates of compliance with displaying prices for all procedures for which it is mandatory,” the Pioneer Health report states. “Compliance rates ranged from a low of 60% to a high of 97%.

Researchers found price variations ranging from nearly 100% for an abdominal ultrasound to more than 300% for an MRI of a leg joint, according to the report, authored by former Under Secretary of State Barbara Anthony consumer and business regulation, and Serena Hajar.

Other variations cited in the report include the price of a mammogram of both breasts, which ranged from a high of $962 at Lahey Hospital & Medical Center in Burlington to a low of $392 at South Shore Hospital in Weymouth. The price of a routine EKG fluctuated from a high of $239 at Tufts Medical Center and $223 at Brigham and Women’s Hospital and Massachusetts General Hospital to a low of $86 at Carney Hospital and Morton Hospital and Medical Center.

“These disparities portray a market dominated by certain systems capable of keeping prices above competitive standards,” the report said. “That’s why provider price transparency is crucial information that consumers, employers, benefit managers and insurers should have easy access to.”

The report, released Thursday, lays out a menu of recommendations, including the establishment of an administrator responsible for price transparency in each hospital, stronger enforcement of federal price disclosure rules and advice from the federal government on how to to make pricing websites mainstream. friendly. At the state level, the report suggests creating incentives to improve hospital compliance rates.

“The lack of information on health care prices may not be a problem for some consumers because they have good health insurance and therefore believe that price is not important,” the report said. “This is a mistake, however, because we all directly or indirectly pay for rising healthcare costs through higher insurance premiums. In many cases, however, the lack of price transparency poses a problems due to health insurance with high deductibles or situations where consumers are underinsured or uninsured Lack of price transparency has unfortunately become entrenched in the US healthcare system.

While hospitals fail to disclose pricing to consumers, researchers found that Massachusetts hospitals are “doing quite well ‘to meet the requirement that all of their pricing be available in a machine-readable format’. for the benefit of employers, competitors, insurers, governments, and researchers.

“Only 2 in our sample of 19 do not make this data available in MRF style. Although a number of national surveys have criticized this requirement and the massive amount of data it produces in an unorganized way, there are here is an opportunity for large purchasers of healthcare services to leverage and use this data to their advantage,” the report said.

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