For years, hospital pricing has been shrouded in mystery — until you get that ginormous bill that seems to have no rhyme or reason. But as of January 1, hospitals are required to post prices for all services and procedures rendered online for patients to see.
The new law, which is part of the Affordable Care Act and administered by the Centers for Medicare and Medicaid Services (CMS), aims to make sticker shock for hospital visits less of an issue — but it may not be all it’s cracked up to be.
Hospitals have to post pricing lists online, but here’s the fine print
Before you get too excited, don’t expect “gotcha” pricing to be a thing of the past just yet: A reading of the fine print of the new law stipulates that all the hospital’s “standard” charges should be posted on the internet.
That means all a medical facility has to do is make the case — which likely won’t be challenged — that it is administering care that is above and beyond “standard” to get away with charging you exorbitant prices.
Another variable is that the prices are not likely to match what your insurance or Medicare is paying. Customers won’t readily be able to tell if the pricing is a total charge or what they’ll pay out-of-pocket.
Furthermore, some nonprofit hospitals base their pricing on income level, further muddying the waters on clear pricing.
So what does it all mean? It means these newly revealed master price lists, which must be updated annually, might not be as helpful as they seem at first glance. In fact, the numbers should be considered akin to starting points or ballpark figures, rather than wholly accurate prices.
Still, you may be interested in knowing how, why and what you’re being charged for care.
How to find your hospital’s master price list
Before you go in for some treatment, if you can’t find your hospital’s mandatory price list online, call them. Ask to be directed to the link.
We did a sample search on some of the major hospitals around the Southeast to see if we could find their pricing index, formally called a “chargemaster.”
Unfortunately, many hospitals are simply posting downloadable spreadsheets that are nearly indecipherable.
So, when it comes to transparency in hospital pricing, are we there yet? Not really.
Or, as one pediatrician artfully said on Twitter: “Posting lengthy Excel sheets of prices that don’t represent actual billed amounts or what patients pay isn’t really being