Hospitals now must post list prices for their procedures
Not only should they list the cost, but they should explain them also. People should go to the hospital information assistance office and ask all the questions they need to understand why prices are so high for small procedures.
Experts say the new federal requirement is a step toward transparency, but hospitals say they can offer more useful information on what patients will actually pay.
Hospitals on Long Island and around the country have been required since Jan. 1 to post online what they charge for their services, ranging from bladder examinations to ventricular shunt procedures.
The new federal requirement is a good but incomplete first step toward helping patients understand the high cost of services, health care and hospital experts said. The required listed prices, they said, aren’t all that insightful because patients rarely pay those full prices.
Health systems also offer patients information assistance that’s more realistic than the required list prices, experts said.
“Health care price transparency can potentially be useful. because it will shine a light on the high price of health care,” said Larry Levitt, a senior vice president at the Kaiser Family Foundation, a nonprofit that focuses on health care policy. But the new requirement alone is “not going to be helpful for consumers to use as a guide to shop around, because there is a difference between the list prices and the prices insurers negotiate with health systems. The negotiated price matters. The listed price doesn’t tell consumers very much.”
Most patients also often don’t know detailed aspects of their procedure, which makes it difficult to know what a final cost would be, said Brian Fullerton, director of revenue cycle at Stony Brook Medicine. Various health systems also use different formats — which can be hard for patients to interpret — in their lists.
But Fullerton said patients are growing more interested in the cost of care, because “new benefit designs have shifted costs to the consumer.”
“More people have high-deductible plans,” he said. “A $5,000-deductible plan is not small. It can be painful, and people notice.”
Still, even the uninsured won’t pay the list prices, experts said.
As for the list price of an inpatient ventricular shunt procedure at Long Island Jewish Hospital? It’s $17,656. The actual cost of the procedure can vary greatly depending on a patient's insurance.