Hospitals to Post Prices for Procedures

Hospitals say prices could still vary

Tom Puckett
December 31, 2018 - 4:00 am

Buffalo, NY (WBEN) The new year brings a new rule from the Centers for Medicaid and Medicare Services, requiring hospitals to publicly post prices for procedures. There are some concerns among hospitals and health care consultants about the new rules.

Mike Hughes of Kaleida Health compares the pricing to buying a car. "No different in our world, in terms of what something may cost compared to the list cost. It can depend on what kind of hospital it is, whether it's urban or rural, if it's a teaching hospital, as well as insurance," says Hughes. "We have thousands of different charge codes, and it's a lot of work assembling it. We're trying to get some answers from CMS on gray area in the rules as well." Hughes believes CMS is looking for standardization of published formats.

Healthcare consultant John Bartimole says transparency is a good idea, but he still has some worries. "I worry the price you see may not be the price you end up paying," says Bartimole. "In surgery, things could happen that could lead to extras being added on. Also, I would not want people to have sticker shock, because hospitals have many different ways to mitigate the payment."

Bartimole is also worried hospitals could lose money when people can't afford co-pays or deducticbles. He also fears patients may decline procedures because of the cost. 

He says folks should hospital shop, if that's possible. "That is because there are different prices. There's the cost of reimbursements from Medicare and Medicaid, and the Blues. Then there are those who pay out of their own pocket who may have a different price.


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