Local hospitals strive to comply with price transparency rule

·4 min read

Jul. 24—Kern County hospitals are rolling out new pricing information, behind schedule for the most part, as part of a federal push to give prospective inpatients a better look at estimated charges for standard services.

A rule that took effect Jan. 1 requires hospitals to post estimates of how much they charge different parties, including insurers, for at least 300 medical procedures.

Some hospitals are further along than others and compliance levels aren't where they should be, not just locally but across the country. Representatives of several local medical centers acknowledged there's work to do and promised more consumer information will be made available soon, and in a more convenient way.

The Trump administration championed the disclosures, in spite of legal challenges by the hospital industry, to make prices more transparent so consumers and employers can make better-informed, value-conscious decisions. Insurers may benefit as well, and many expect the rule will help drive down prices.

Hospitals are supposed to post on their websites consumer-facing and machine-readable prices including cash discounts and highest and lowest rates paid to contracted health plans. One day soon that data may allow consumers to compare easily understandable hospital data with a few taps on their smartphone.

WIDESPREAD NONCOMPLIANCE

National studies have found the large majority of U.S. hospitals have failed so far to come into full compliance with the rule. A report released this month by the California Health Care Foundation concluded 30 percent of hospitals in the state were fully compliant, 43 percent were partially so and the remaining 27 percent hadn't met any of the minimum requirements.

That has fueled calls from patient advocates to step up federal enforcement of the rule, perhaps increasing daily penalties for noncompliance.

Patient Rights Advocate spokesman Jordan Bruneau said some hospitals in Kern County post just one charge, or sometimes an average of charges.

He noted one didn't appear to have posted any prices at all. The hospital, Good Samaritan Hospital — Bakersfield, did not respond to requests for comment.

"Without this real price information, it's almost impossible for Bakersfield to shop for less expensive care," he wrote in an email.

HOSPITAL PERSPECTIVE

Hospitals as an industry don't agree. They say the information is of little use in the modern health-care system, in which most people are insured and often locked into a given network, with little to no say over where they get care.

"Having this broad look at things doesn't really help most consumers," said California Hospital Association spokeswoman Jan Emerson-Shea.

Already state law requires hospitals to offer a good-faith estimate in advance of prices for 25 procedures, she added, and most consumers don't use the information. People don't shop around for an appendectomy, she noted.

One reason she said hospitals have failed to comply with the new rule is that it took effect during the winter surge of COVID-19, when resources were short and focus went elsewhere.

CATCHING UP

Adventist Health, owner of three hospitals in Kern, said on July 30 it will introduce a patient-friendly price transparency tool allowing consumers to browse for 300 hospital services "in the same way they shop for goods and services online." The online platform will include a price estimator showing patients' out-of-pocket costs.

"At Adventist Health, we are committed to helping our patients make informed decisions about their health care," spokeswoman Megan Simpson said by email.

Another owner of three hospitals in Kern, Dignity Health, said it, too, supports price transparency and is working as quickly as possible to comply with the federal rule.

Spokeswoman Michelle Willow stated the company is compiling negotiated rates with health plans and making sure the information is understandable.

"We expect to begin posting this information over the next several months," she said by email.

"We have offered price estimates to patients in advance of scheduled care for many years, and we will continue to do so going forward," she wrote.

VARIED PROGRESS

Bakersfield Heart Hospital acknowledged the pricing information it provides is not yet universally comparable. A spokeswoman advised patients seeking price estimates to call the hospital so staff can explain operations, variables and available financial assistance.

Kern Valley Hospital already offers an online tool allowing consumers to search prices by the procedure's name or medical code. Prospective inpatients can type in their insurance provider and plan in order to get an estimate. The information is also available in spreadsheet format to make it readable by a machine.

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