TAMPA, Fla. (WFLA) — Some Florida hospitals are pushing back against a new report that says many facilities aren’t posting prices for procedures, as required by the federal government.
8 On Your Side told you about the new report from PatientsRightsAdvocate.org on Monday. Approximately 6,000 U.S. hospitals are currently required to post the price of procedures online. The theory is price transparency will cause you to shop around and, as competition rises, the cost of health care will fall.
While the Trump administration rule took effect Jan. 1, the report found many hospitals are still not following all the federal price transparency rules.
“Of the sampling that we found (out of) over 30 hospitals in Florida, only two were compliant,” said Cynthia Fisher, the founder and chairman of the nonprofit PatientRightsAdvocate.org.
The report looked at a random sample of 500 hospital websites, including more than 30 in Florida.
The list of the noncompliant was long. The report named Tampa General Hospital, AdventHealth, BayCare and Lakeland Regional Health. Wanting answers, 8 On Your Side reached out to those facilities.
In a statement, Tampa General Hospital says it “believes it is in compliance with the intent of this rule… to provide patients easy access to estimate their out-of-pocket expenses.”
BayCare says the deficits refer “only one portion of the new rule” that has to do with a “machine-readable file” for government and researchers, not consumers.
All four hospitals systems say patients can determine out-of-pocket expenses via a price estimator tool online.
“We all know that estimates aren’t real prices,” said Fisher.
Fisher says an estimator tool is one facet of the law. She argues you can only combat price gouging if hospitals must post all actual negotiated rates for all payers and all plans. That way you know if you’re paying thousands more than the next guy for the same procedure.
“They have to produce all of their actual prices online,” said Fisher, “and all of these hospitals just so you know that you talked to that came back, they are not doing that.”
8 On Your Side is still working to sort out all of the details.
Below we have listed the full statement from the hospitals:
“Tampa General Hospital believes it is in compliance with the intent of this rule, which is to provide patients easy access to estimate their out-of-pocket expenses. TGH is committed to providing transparency when it comes to health care costs. Patients have access to the TGH Price Estimator that will share detailed information on their financial responsibilities.”
“We provide an interactive and personalized price estimator for hospital services so that consumers have a clear picture of their financial responsibility in advance of receiving elective services. Additionally, we provide a payment calculator and details about bills and payments to assist consumers in making informed decisions about their health care.”
Lakeland Regional Health statement:
“Lakeland Regional Health is committed to providing price transparency for our patients and families. The price estimator tool that is accessible on our website allows consumers to shop for a large number of hospital services to determine estimated out of pocket costs based on their specific health insurance plan benefits.”
“BayCare has a long tradition of price transparency for shoppable services for our patients. For years we have provided estimates to patients for elected procedures and upon request for other services. Even ahead of the new federal rule, in 2019, we added the online MyEstimator pricing tool so patients can get answers 24 hours a day. Individuals can also call our Central Pricing Office at (813) 852-3116 Monday through Friday from 8 a.m. to 4:30 p.m. to obtain a price estimate.
The deficits you listed in regard to the new federal regulation refer to only one portion of the new rule. It has little to do with consumer information and is more about providing private business information to government and researchers via a “machine-readable file.” Compiling this file requires thousands of hours of efforts on providers’ part to comply and maintain in what has already been a challenging time due to COVID-19. BayCare is working to meet this requirement. The good news for consumers, however, is they are already well served with the tools and services we already provide that deliver price estimates tailored to their specific insurance plan’s deductible, co-pays and other benefits.”
Here are the tips from PatientRightsAdvocate.org on how to shop for best quality of care at the lowest price:
- Check out resources like Turquoise Health, FireLight Health, and My Medical Shopper to compare prices across hospitals.
- Look on your local hospital’s website for both the discounted cash (self-pay) price and your insurer’s negotiated rate. The cash price is on average 39% cheaper!
- Check for the discounted cash prices and the negotiated rates at nearby hospitals that are posting complete price lists for the exact same procedure you are looking for.
- For planned surgeries and procedures, look up prices at price transparent surgical centers like the facilities below, and use them to negotiate with your local hospital
If you cannot find prices online:
- Call your local hospital and “DEMAND” them. According to a federal rule, starting on January 1, 2021, hospitals are required to show you their prices.
- Report the hospital to the Centers for Medicare & Medicaid Services (CMS) on the CMS website.
- Write to the Management Team and Board of Directors of the hospital to let them know they are not complying with the federal rule that makes it your right to easily access prices online.