MYRTLE BEACH, SC (WBTW) — Patients are now able to see the prices of health care services before they seek them, according to a new, federal rule that went into effect at the beginning of this year.
“It is absurd that we have not been able to know prices in health care,” said Cynthia Fisher, the founder and chairman of Patient Rights Advocate, a national nonprofit organization that works for price transparency in the health care industry.
Starting Jan. 1, medical institutions are required to post the prices they use to negotiate with insurers and the discounts they offer to customers who pay in cash. Under the rule — a push from the Trump administration — the price for every service, drug and supply a health care provider offers must be publicly put online.
Health insurance companies must do the same starting next year.
The health care industry challenged the rule last year in court, claiming that it forced hospitals to reveal trade secrets. The rule has been upheld by the U.S. Court of Appeals for the District of Columbia.
“This is a huge win,” Fisher said. “The judges ruled in favor of the American consumers.”
Hospitals have been complying in different ways, with some posting price estimate calculator tools, others posting charges and others using chargemasters, a document that can have tens of thousands of medically-coded options.
“Some are posting them in a more complicated way that is going to take extra steps and computer tools to get access to, but we think the real winners of this whole shift are the ones who are making it more easy for the customers,” said Fisher, who highlighted Midland Orthopedics and Neurosurgery in Columbia as an organization that has made its prices easier to understand.
Fisher said some medical facilities are only showing estimates, and others did not initially make the prices easily accessible. Fisher said changes will take more advocacy from patients seeking costs.
“Grand Strand Health is committed to supporting efforts to provide relevant information to help patients understand what their out-of-pocket costs may be for hospital care so they can make informed decisions,” a written statement from Katie Maclay, a spokeswoman for Grand Strand Health, reads.
Maclay said the health care organization began posting billing information and pricing estimates online in 2007.
Fisher said it’s important for health systems to show real prices, not estimates.
“Estimates do not work,” she said. “They are not real prices.”
Fisher said she’s heard from patients that the cost of their procedures ended up being six times the price they were quoted.
The rule requiring prices, she said, will allow patients to shop around for a procedure. She said she’s seen prices for knee replacements, without complications, range from $20,000 to $75,000, depending on the hospital.
She expects the rule to ultimately bring down prices and said it will help people to not be blindsided by final costs. She also anticipates the rule will bring about an economic stimulus as people who have been afraid to seek care learn what the real prices are.
McLeod Health has published several price sheets based on location. The sheet for McLeod Regional Medical Center in Florence includes more than 20,000 rows of items.
Tidelands Health has posted a handful of different downloadable documents on its website, including one that displays costs compiled for about 375 items, and another that breaks down services into more than 79,000 rows.
Requests for comment from McLeod Health and Tidelands Health were not returned, as of deadline. A representative from Conway Medical Center said they were not able to facilitate an interview before deadline.