A faulty step in the right direction

Published 5:13 pm Tuesday, January 8, 2019

Due to new guidelines from the Centers for Medicare and Medicaid Services, hospitals around the country were required to post pricing information online by Jan. 1.

WellStar West Georgia Medical Center in LaGrange and East Alabama Medical Center in Valley published their lists of pricing to meet the required guidelines, allowing consumers a chance to see the cost of medications, procedures and supplies.

Unfortunately for anyone with insurance, the list is basically useless. This the case for all of the chargemaster prices posted by any hospital in the United States — all are fairly pointless because the lists generally don’t reflect what a customer will actually pay. It’s more useful for people without insurance, who can compare their options, and may actually be able to save some money.

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Some hospitals have organized the pricing, making it comprehendible for the average person. East Alabama Medical Center has seemingly worked to organize the information, making it so customers can search to get comparable prices. For 25 of the more common procedures, you type in what you’re looking for and a price quote pops up, giving the customer a general idea of what it costs before insurance. It’s easy to use and easy to understand.  A .CSV file is also available for anyone wanting to see all of the pricing information for all operations.

WellStar’s pricing was put online in .txt files and is more challenging to sort through. If you don’t remember what a .txt file is, it’s essentially what you get when you open up “Notepad” on a Windows 95 PC.

There’s no search functionality and there’s no apparent rhyme or reason — at least to the average person — for the pricing. You can use your browser to search the page, which helps, but it’s a very confusing list of information. For instance, if you search “aspirin” there are 13 different options, depending on the type and dosage size, but even that part isn’t easy to distinguish. Hydrocortisone ranges anywhere from a few dollars to hundreds of dollars, based on myriad factors.

And that’s just the things we could find that are actually somewhat understandable.

The procedure list is even more difficult to navigate, as most of us aren’t familiar with medical terminology for most surgeries. Abbreviations are used throughout the list and 14,563 different procedures are listed. If you need to find one, good luck.

The Centers for Medicare and Medicaid Services has referred to posting pricing information as the first step in making things easier for consumers, and it makes sense. Medical procedures are one of the few times in life where we often have no idea what we will end up paying. It’s like going to a mechanic with a broken-down car and not getting an estimate before any work is done.

That’s essentially what we all do with our medical care, hoping insurance will cover all, if not most, of the cost. When we open a hospital bill or go to the pharmacy to pick up a new prescription, most of us just hope for the best.

Insurance companies — and not hospitals — obviously take on a lot of the burden for the final price paid. And anyone with pricing questions should contact their local hospital and their insurance company to try to find out how much a procedure will cost. There’s just got to be a simpler way to disperse that information.

The posting of pricing information is a step in the right direction, one that can only lead to more transparency and a fairer market for consumers. But it’s important to note that the information is extremely complicated and over the head of most in the general public, making it nearly worthless if it’s published in a complicated format.

Hospitals should do their part by publishing that complicated information in as simplified a way as possible. If they don’t, there’s almost no gain for the consumer.