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NPR: Hospitals Forced To Be More Transparent About Pricing. Will That Save You Money?

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NPR writes: With the new hospital rule requiring hospitals to post prices of services on their website that came into effect Jan 1, consumers should be able to see the variation in prices for the exact same care among hospitals and get an estimate of what they will be charged for care — before they seek it. The new data requirements go well beyond the previous rule of requiring hospitals to post their “chargemasters” — the hospital-generated list prices that bear little relation to what it costs a hospital to provide care. Also, few consumers or insurers actually pay those listed prices.

The following outlines what consumers should know:

  • How will this work? Each hospital must post publicly online several prices for every item and service they provide: gross charges; the actual, and prices they’ve negotiated with insurers, including de-identified minimum and maximum negotiated charges; and the cash price they offer patients who are uninsured or not using their insurance.
  • Will prices be exact? No. At best, these are ballpark figures.
  • Who else will use this information? It is doubtful that the data alone will make much of a difference for most consumers. However, the information may be of great interest to the uninsured and to the increasing number of Americans with high-deductible plans, in which they are responsible for hundreds or even thousands of dollars in costs annually before the insurer begins picking up the bulk of the cost.
  • Will price transparency reduce overall health spending? Revealing actual negotiated prices, as this rule requires, may push the more expensive hospitals in an area to reduce prices in their future bargaining talks with insurers or employers, potentially lowering health spending in those regions. It could also go the other way, with lower-cost hospitals demanding a raise, driving up spending.

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