The Trump administration sounded in 2019 adopting an apparently great health policy: to oblige all hospitals to list the price of their most common procedures on their websites.
The idea was to make the US health care system more transparent by allowing patients to research the cost of care in thousands of hospitals across the country.
"We are just starting to make price transparency," said Seema Verma, Medicare Administrator when she announced the policy last April. "We know hospitals have this information and we ask them to post what they have online."
His goal made a lot of sense: it's really It is difficult for patients to seek health care prices in our current system. A 2013 study found that almost all hospitals could tell you their parking fees – but almost none could provide an estimate of the cost of their health services.
The federal government has had this data on hospital fees for some time now. actually, I wrote about it five years ago, for the Washington Post, when it was created.
Overall, the liberalization of health care data appeared to be a common sense and well-intentioned policy. And, on January 1, the policy was applied to the real world. We soon found major gaps in this effort to increase price transparency – explanations that show how difficult it is to give patients good cost estimates in a health system characterized by secret pricing.
One of the biggest gaps? The data published by hospitals can be difficult to find and analyze. I've been looking at prices in some of my local hospitals in Washington.
I usually needed about five to ten minutes of research on their websites to locate the price data – not great, but not terrific either. Once I found it. … This is where things became interesting.
I found the price data at George Washington University Hospital quite easily. But to see it, the hospital asked me to tick several boxes, recognizing that "the price estimates are likely to change" and that "the fees do not reflect the responsibility of the provider or the patient". to be the prices I would face as an inpatient.
After clicking on the list, I arrived at the prices themselves. This is a 4,920-line spreadsheet that looks like this:
George Washington University Hospital
I can not tell you what a "COMP 2 -D ECHO TTE NO CONTRST" is, and I suppose most patients could not either.
And even though I knew what a "COMP 2-D ECHO TTE NO CONTRST" was, it was not clear that knowing its price of $ 2,283 would help me a lot either. These are the prices that George Washington Hospital charges for health care, but it's not the prices that insurers pay for health care. These prices are negotiated in secret and are not available in this dataset. Some research has shown that the real prices paid by insurers and patients bear little relationship published charges.
This is not to be taken for George Washington University Hospital. This is exactly what the newly available fee data from many hospitals look like. Like Robert Pear written In today's New York Times, "the data, posted online on spreadsheets for thousands of procedures, is incomprehensible and unusable for patients – a mixture of numbers and technical medical terms, presented in formats that vary from one hospital to another. "
So, how should a patient use this new wealth of charge data? I thought Martin Gaynor from Carnegie Mellon University had the best interpretation recent interview he gave Marketplace:
Adams: So what can consumers do with this information to help them make more informed choices about their health care costs?
Gaynor: I would not say anything. I do not think this is useful information. Now, it may be a step in the right direction. Perhaps the government is starting here and wants to move in the direction of disseminating information that people can actually use for them and that are usable, but that's not the nature of that information. I do not think that's helpful, and I do not think consumers should pay attention.
I would be a big proponent of making the data on health care prices more available. That's the point of the emergency billing project I've been working on for a year at Vox. Unfortunately, I agree with Gaynor: this new dataset will not really help patients. It's hard to analyze and does not say much about what you or I would pay for our visit to the hospital.
The Trump administration could do some things to make this dataset a little more user friendly. They could take a page of how California regulates price transparency. This state requires hospitals to support the 25 most common procedures in a user-friendly format. All these documents are available on a website managed by the stateThis means you will not have to spend time digging through each hospital's website.
These leaves are much easier to read than the one above from George Washington University Hospital. Here is, for example, part of the hospital spreadsheet I wrote about recently: the Zuckerberg San Francisco General.
Zuckerberg San Francisco General
What I like about this data is that it is written in plain English. You can understand to which medical services the different prices correspond.
But, again, even these data face significant limitations. These are still billed data – they do not show the prices that insurance plans negotiate for the patients they cover.
So unless you're in a hospital that does not negotiate prices with private insurers – which Zuckerberg does not do, but the vast majority of hospitals do – this billing data will still not tell you much about your bill of support for medical expenses. services.
Making this data available means doing more than just posting billing lists. This means making public the millions of prices that hospitals and insurers are currently negotiating in secret. These are the data that patients really need to understand the cost of their hospital trip – but for now, this is the data that patients still do not have access to.
This story is published in VoxCare, a Vox newsletter on the latest twists in the health care debate in America. Register for receive VoxCare in your inbox with more health statistics and news.
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