WASHINGTON – Americans can easily compare prices when shopping for almost any item or service they desire – except medical care.
Colorado Sen. John Hickenlooper introduced a bill this week that would require health care providers and facilities to publish the costs of their services, aiming to improve transparency.
“You wouldn’t book a flight if you couldn’t find out the ticket price until you land – or check into a hotel without knowing if you’re paying for the Ritz or a dump,” said Hickenlooper in a written statement. “But that’s the absurd guessing game Americans play every time they need medical care.”
The bipartisan bill, cosponsored with Sen. Roger Marshall, R-Kan., would codify an executive order issued by President Donald Trump in February that aimed to standardize price transparency requirements.
By requiring providers to disclose all negotiated rates and cash prices, rather than estimates, patients would know exactly what they’re paying beforehand.
“If it’s an emergency, clearly you’re not going to stop and find out what the cost is in that situation,” said Doug McCarthy, CEO of Local First. “But if it’s an elective procedure, like a knee replacement, hip replacement or even a mammogram, you might be able to shop around and find that same service for a cheaper price.”
McCarthy said when people are more cost-conscious about how they interact with the health care system, not only will they save money, but it would also slow the rise of insurance premiums, benefiting everyone.
The legislation would first require hospitals to post the actual prices of 300 shoppable services, followed by all services starting next year.
Mercy Hospital displays pricing for many common medical procedures, and even allows patients to select their insurance company to see prices with their particular plan. However, not all hospitals and providers are in compliance with Trump’s executive order.
The bill would also require facilities to issue a detailed itemized bill of their service to patients. Adam Fox, deputy director of Colorado Consumer Health Initiative, said that provision could have a more meaningful impact than many might realize.
Patients who go to CCHI with medical billing issues, claims questions or insurance appeals usually must request an itemized bill before they can receive help. If itemized bills are issued beforehand, it could significantly speed up the process of resolving such matters.
Advocates say the legislation is a step in the right direction, but transparency alone is not enough.
“Research shows that transparency has a modest effect on prices, so this isn’t the silver bullet that’s going to solve all problems for making health care more affordable,” McCarthy said.
There are many situations where patients may be unable to shop around for services they need, despite pricing being widely available to the public. Especially in rural areas, residents might only have access to one facility where they can get care.
Still, McCarthy said, “this is one of the tools in the toolbox that we need.”
Richa Sharma is an intern for The Durango Herald and The Journal in Cortez and a student at American University in Washington, D.C. She can be reached at rsharma@durangoherald.com.
