EAMC posts pricing online
As of Jan. 1, EAMC and EAMC-Lanier joined every other hospital nationwide in posting their pricing for medical procedures from dialysis to drug testing online for the public to view.
The move comes after an August 2018 ruling by the Centers for Medicare and Medicaid Services, or CMS, that requires all hospitals to post their pricing in an attempt to provide better access and transparency to patients.
On EAMC’s website, under Patient and Family Resources, prices for the top 25 procedures in surgical, cardiology, laboratory and radiology can be found and sorted by price and description. Also listed are nearly 9,000 individual charges in a machine-readable format as required by the new rule. The site warns that the pricing is only an estimate, though, as the price one pays for services is largely dependent on insurance and other variables.
“While we, along with most hospitals, are not opposed to sharing these prices publicly, the consensus among hospitals is that it’s not likely to be as helpful as one might think,” said EAMC spokesperson John Atkinson. “That’s because nearly all of a hospital’s payments are set either by government, which generally pays less than the cost of caring for patients, or through negotiations with private insurance companies. As a result, patients do not pay the itemized charges listed on the hospital bill.”
Additionally, pricing information can be even more misleading in Alabama due to the wage index factor applied to Medicare payments in the state. As the Alabama Hospital Association describes it, the wage index is “a complicated formula used nationwide to determine how much a hospital is paid for providing care to Medicare patients” based on hospital staff wages. If wages go up in any given area of the country, the wage index follows suit.
The AHA states that 40 percent of all hospital care in the state is covered by Medicare, so with Alabama ranking at the bottom in terms of the wage index, the majority of Alabama hospitals like EAMC-Lanier have the lowest reimbursement rate in the country.
“That means that many Alabama hospitals get paid about half as much as hospitals in other parts of the country,” Atkinson said. “And the Medicare payments even vary around Alabama.”
Hospital officials urge Alabamians to check their insurance policies to get the full picture.
“Patients are certainly welcome to view these charges, but what’s probably more important — and what we have always recommended — is that insured patients check with their health insurance company to get a better estimate of what amount they will be responsible for as a co-pay or deductible,” Atkinson said.
Congressman Mike Rogers, who represents Alabama in the U.S. House, encouraged anyone with problems regarding hospital pricing to contact his office.
“I support any and all moves by CMS to cut red tape for hospitals and providers in Alabama,” Rogers said. “… I would encourage any patients or providers to reach out to my office if they encounter any issues with it.”