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Hospital systems and clinics are required to post prices online, but are they?

Posted at 2:18 PM, Oct 27, 2021
and last updated 2021-10-27 18:28:50-04

(WXYZ) — Hospital systems and clinics are now required to post their prices online. You’re supposed to be able to shop to get the best price near you.

The process started with Obamacare, and President trump signed an executive order mandating it.

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Recent studies, however, show that only 9% of people know the price websites are available. And only 14% of people use them.

You’re supposed to get real prices online, including what it costs you to pay cash, what it costs your insurance company with rates they negotiate. Critics say, it’s not happening.

"In no other place of our marketplace in the economy would any of us tolerate not knowing the prices up front and having financial certainty," said Cynthia Fisher, of PatientRightsAdvocate.org.

Marianne Udow-Phillips of the Center for Health and Research Transformation says, "The way we set healthcare in the U.S. is just so much more complicated than the way any other country does it and the rest of the world. In the rest of the world, they set hospital prices."

Metro Detroit health systems have set up what are called charge master websites, but they are complex and not necessarily user friendly.

Some offer people you can call to get answers. Critics say, these can be estimates, not prices. "Estimates are yet one more dark shadow curtain pulled in front of the patient to keep them in the dark," said Fisher.

"That is a factor of what our copays, our deductibles are, what particular type of service we're going to have. So it's a very complex problem," said Udow-Phillips.

Some websites like turquoise.health gather the data and help you sort out prices from providers near you here in metro Detroit.

And get this: more costly confusion.

Look at random prices for a CT Scan of an abdomen, or an MRI of the brain, or a joint replacement, a $36-thousand difference in costs.

Surgical centers verses hospitals, and the volume of procedures performed can affect prices.

"From studies that we have seen report after there is no correlation between price and quality of care," said Fisher.

Fisher’s the founder of PatientRightsAdvocate.org and says many service providers deliberately keep it confusing.

"We found that only 5.6% of those hospitals are compliant with the law," she said.

She’s advocating even more simplicity, having websites like the ones that list airline prices.

But the Ann Arbor-based Center for Health and Research Transformation says that’s not a good comparison. "I think the better approach for consumers is for health plans to give consumers what they would owe at different facilities," said Udow-Phillips.

That will be mandatory next year.

The University of Michigan Hospital is signed out as being the most transparent. "We applaud hospitals like the University of Michigan that has actually complied," said Fisher.

Fisher says the Biden administration is considering fines up to $2 million for those who don’t comply.

The Michigan Hospital Association sent us a statement that says many hospitals have provided prices online for years and that there’s ambiguity in the final rule for posting prices.

Read the full statement below:

"For years, our member hospitals and health systems have voluntarily provided patients with upfront information about their costs and healthcare quality, including through cost estimator tools and other services such as our verifymicare.org [verifymicare.org] website. Many hospitals have had pricing tools on their own websites for years.

Both the MHA and the American Hospital Association have been providing information and guidance to our membership on implementing the price transparency rule requirements. Some parts of the rule require significant staff resources that have at times needed to remain directed at the COVID-19 response or been limited by the on-going healthcare staffing crisis. In addition, there is ambiguity within the final rule that has left hospitals to interpret the level and detail of pricing information that should be provided to consumers.

Hospitals and health systems are working diligently to comply with federal policies in their release of information. Because every healthcare experience and service are unique to the needs of that individual patient, we always urge people to contact their provider to discuss the potential costs of their care and understand what their cost sharing responsibilities may be."