An article in Health Affairs analyzed hospital discounted cash prices as posted on their Websites in compliance of the Centers for Medicare and Medicaid Services’ (CMS’s) Hospital Price Transparency Final Rule which came into effect January 1 2021.
Their case study provides a clear example of the potential utilitization of these hospital discounted cash prices by patients. In their example, an insured patient in a high-deductible plan who has not met their deductible and is in need of an outpatient colonoscopy may have saved (based on highest negotiated commercial rate at each hospital) as much as $569.00 at Massachusetts General Hospital (MGH), $1,714.90 at University of Michigan Health System (UMHS), and $760.76 at VMC, simply by not billing their insurance and instead paying the cash price. Moreover, a self-pay patient seeking an MRI could potentially save $1,095 by changing hospitals and paying the cash price at UMHS instead of the average commercial price at Vident Medical Center (VMC). While in their example these two hospitals are not geographically proximal, thus mitigating the potential savings for patients seeking an MRI, these types of savings likely exist at more geographically proximal facilities.
While the authors acknowledge there are many questions yet to answer relating to this data, they believe that discounted cash price could potentially be of great utility to patients. As such, researchers and policy makers should not discount this new discounted cash price data and instead work to validate it.