New rule will force all U.S. hospitals to post prices for common procedures

Hospitals will have to list pricing for common medical procedures online starting Jan. 1, 2019.
Hospitals will have to list pricing for common medical procedures online starting Jan. 1, 2019.(WOIO)
Updated: Dec. 27, 2018 at 6:05 PM EST
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CLEVELAND, OH (WOIO) - A new federal rule will require all U.S. hospitals to post the prices for common procedures starting in the New Year.

This will allow patients to compare prices for medical procedures.

In a Cleveland19 Investigation a month ago, we found that asking a few simple questions could save you thousands of dollars.

Jeanne Pinder is the founder and CEO of ClearHealthCosts. She recommends asking a few key questions when it comes to your medical care.

“How much will that cost? How much will that cost me on my insurance? What's the cash price? That's right, for somebody that's not insured. And then, please put that in writing?” Pinder said.

The new federal rule requires hospitals to post pricing information online that will allow consumers to download a spreadsheet.

“Everybody should know what stuff costs in health care. As it stands now, you don't know before, during or after the test or procedure what it's going to cost you,” Pinder said.

GF Default - Cost of Health Care
GF Default - Cost of Health Care

But it still could be confusing.

The rates you'll see listed don't reflect what insurers and government programs pay.

When it comes to out-of-pocket costs, everyone will be paying very differently, depending on insurance coverage and benefits.

Jeanie says the new federal rule doesn't go far enough to help you-- the consumer.

“We think CMS needs to ask hospitals to do the right thing not only by hosting their list prices, but posting next to that the price that Medicare pays for the exact same service or procedure,” Pinder said.

Cleveland19 reached out to University Hospitals, Cleveland Clinic, MetroHealth System and Summa Health for a response to the new federal rule.

A few hospitals pointed out they already post some patient pricing information online, complying with state law. Here are their responses:

University Hospitals

UH sent us this webpage for patient pricing information that currently complies with Ohio state law.

A UH spokesman says he expects the page will be updated by or even before January 1, to be compliant with the new federal law.

Cleveland Clinic

“Since late 2016, Cleveland Clinic has made estimates for care available to patients when scheduling surgical and diagnostic services and upon request for all other services.

We have fully complied with the CMS requirement by posting our comprehensive hospital charges list on our website. Most patients do not pay these rates as their specific healthcare plan coverage determines any out-of-pocket charges.

Our financial advocates are available to help patients understand and calculate their potential financial obligations before they receive care. An online estimation tool is also available on our website. We also provide financial assistance to patients who qualify.”

More information can be found on our website.

Metro Health System

MetroHealth embraces accountability and transparency in health care pricing. We have traditionally posted the pricing of frequently used services on our website, and starting January 1, we will list hospital charges for each inpatient and outpatient service or item provided by our System, per the new CMS rule.

A hospital’s charge is the dollar amount that is billed to insurance companies, however is typically not what a patient will be responsible for paying. A patient’s individual financial responsibility will vary depending on their type of insurance coverage and benefits.

We have representatives who can help assist with providing patients with out of pocket estimates and also financial coordination, whether you have insurance or not. For help, please call 216-778-3010. A link to the patient tool for cost estimation can be found here.

Summa Health

“Summa Health supports pricing transparency and our chargemaster is available online in accordance with all state and federal regulations, including the new CMS guidelines. Because many different factors are used to determine actual patient financial responsibility we encourage anyone with questions to contact our patient access center at 888.446.5154. Our representatives are available to help and have tools to best provide answers to specific questions.”

Mike Bernstein, Summa Health

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