Cost Transparency in Healthcare: What This Means For You

When the clock struck midnight on January 1, 2019, we cheered for more than the New Year. With the new year brought a new law: cost transparency in healthcare is now mandatory. As of January 1, hospitals have to publicly post the cost for the services they offer. We are especially excited about this change. At Denials Management, we are passionate about patient and consumer advocacy. We believe that patients have a right to know about their healthcare needs, including the cost of what common healthcare services will cost.

This new era of hospital price transparency is a part of the sweeping Medicare program enacted by the Trump administration. The change is an effort to encourage patients to be better-educated decision makers when it comes to healthcare. The idea is that if a patient knows how much a procedure will cost at several participating hospitals, they can determine where and who they want to see from medical care, the same as they would for an oil change on their car.

How Medical Professionals Feel About

Cost Transparency in Healthcare

The exposure of hospital prices has been met with mixed support from the medical community. The most common complaint is that even if the prices are posted online, it will not give consumers a factual estimate of what their hospital stay will cost them. Providers and hospitals argue that no one knows if there will be complications with procedures like surgeries, so visiting a website and seeing the cost of the procedure is misleading. Different patients have different recovery times as well, argue hospitals, so posting the prices will lead to confusion and improper budgeting for what might not reflect the true price of services. In addition, experts point out that some services like x-rays vary in cost depending on what part of the body is being x-rayed, and compiling a list to detail every possible scenario is impossible.

How We Feel About Hospital Price Transparency

Despite the limitations, we see the hospital price transparency as a positive step forward for patient rights. However, we do believe that more must be done. Along with most other proponents of the change, we agree that the data posted by hospitals must be easier to read. We also agree that the prices need to be posted in common terms, and avoid the medical jargon of codes, abbreviations, and acronyms. Finally, and most importantly, the prices need to be easy to find for patients, including those who are not computer savvy. 

This was stressed by our vice president, Whitney Duhaime, when a local news station reached out to Denials Management for comment on the changes: “I can’t believe how many things they make you click through.” In one example, Ms. Duhaime had to navigate seven screens deep into a hospital’s website before finding the prices. Hiding the prices behind layers of a website defeats the purpose of posting them at all, and we believe that these prices should be prominently displayed on hospital homepages.

While this is a positive step forward, there is still a lot of work left to do to achieve true cost transparency in healthcare. One integral aspect that DMI would like to see moving forward is the opportunity for individual patients to negotiate the prices of services, not just the insurance companies. We also want to see a more detailed partnership with patients and providers, where patients can choose services and healthcare providers based on cost in mind.

Cost Transparency in Healthcare Moving Forward

At the end of the day, regardless of whether you know the price beforehand or not, we believe that healthcare costs can be crippling for individuals and families, even if you have private insurance. That is why DMI is committed to continuing to advocate for customers and patients, one appeal and one claim at a time. While we will continue to support high-level changes to the healthcare system, we are also eager to help patients on an individual level. If you have healthcare bills piling up, we are here to help. Our dedicated team of advocates is ready and standing by to help you get the money that you deserve.