NORTH TEXAS (CBSDFW.COM) – Want to know the price of your next medical procedure?
Starting this year, the Trump Administration is requiring all hospitals to post their prices online.
Patients are supposed to be able to use these prices to shop around and find deals.
While the effort maybe well-intentioned, the online prices for most patients are confusing and often useless.
“The chargemaster is fictitious prices that only the uninsured pay and even the uninsured probably don’t pay them,” said health economist Devon Herrick with the think tank The Heartland Institute. “It’s not very useful.”
The Problem: Surprise medical bills
When Dayla Beauchamp, a teacher in North Richland Hills, went in for gallbladder surgery, she thought she knew what she was getting into.
“It was going to be a quick outpatient procedure,” she said. “They were going to be making small incisions so I was thinking out of pocket for me around a couple of thousand dollars.”
Two months later, the bills started stacking up.
“You are going ‘oh my word I still owe this much’,” said Beauchamp whose out-of-pocket costs were more than double what she expected. “It would be nice to have everything up front to know how much it is going to be.”
Beauchamp said she doesn’t know if what she was charged for her procedure was “normal” or if she could have gotten a better deal at a different hospital.
“I don’t know,” she explained. “There is no way to know.”
Federal hospital price rule creates patient confusion
The Trump Administration’s push to put an end to surprise hospital bills led to the new rule requiring hospitals to post their chargemaster price lists on its websites.
While the majority of North Texas hospitals met the federal deadline of January 1st to post their price lists, many health economists question the lists’ value.
“For it to work it has to be real transparency,” Herrick said. “It can’t just be putting up list prices that no one actually pays.”
The CBS 11 I-Team looked at the chargemaster lists for dozens of North Texas hospitals.
Many lists were hard to find on the hospitals’ websites and even harder to decipher.
Most price lists are spreadsheets thousands of lines long filled with billing codes, abbreviations, and medical jargon.
How many average consumers know what this means? “SP IVUS NON-CORON INIT VESL.”
Even if one can figure it out, the prices listed are typically not the patient’s costs.
DFW Hospital Council President CEO Stephen Love said the chargemaster prices are used by hospitals as a starting point for negotiations with insurance companies.
“Posting the chargemaster prices I don’t feel is going to be very meaningful to the average consumer,” he said.
Even while complying with the new requirement, many hospitals have posted disclaimers warning consumers not to rely on the data.
North Texas hospital go beyond federal requirement
Many North Texas hospitals have online tools to help customers estimate their medical costs.
Methodist Health System has a list on its website of the price ranges for its most common procedures.
Medical City hospitals have a similar list on its websites with price ranges for common procedures for uninsured patients.
Baylor Scott & White has a cost-estimating tool that give patients an instant estimate.
Most of these online pricing tools come with a disclaimer that the prices are only estimates.
“Hospitals strive to give ranges and we estimate this is what it is going to be your out-of-pocket expense,” explained Love. “The actual price can be difficult because health care is not an exact science.”
Most local hospitals also advise patients to meet with one of its financial counselors prior to a procedure for more personalized cost estimates.
Herrick advises when speaking to a hospital financial counselor be sure to ask for the out-of-pocket expense and, if insured, be sure to ask if any part of the procedure will be out-of-network.