CMS enforces new price transparency rules for hospitals

Published: Jan. 2, 2019 at 9:31 PM CST
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The Centers for Medicare and Medicaid Services has released new regulations that might make it easier to see how much you will pay for a visit to the hospital.

The change requires hospitals to post all standard charges on their websites. It’s a way to promote transparency and help you understand your healthcare.

Pricing transparency has become a real hot topic within healthcare primarily because of the higher deductibles people are paying.

"This is the future for healthcare," Avera Senior Vice President of Marketing, Kendra Calhoun said.

The new rule went into effect yesterday. It requires all hospitals to make prices available on their websites that way you can find how much a particular procedure will cost before insurance.

"The intent is to have transparent pricing and have people better understand the costs of their healthcare,” Sanford Vice President of Finance, Cole Turner said.

Experts say you should be asking how much things cost and calling your health insurance provider can help. They will have the most accurate information for you because everybody's coverage is different.

"We’ve got to be able to provide price information for consumers because they will shop. They want to shop like they shop Amazon and we've got to make it easier for consumers and we got to make it a better experience for consumers," Calhoun said.

Avera and Sanford both have financial services in the hospitals to help patients determine out of pocket costs.

"We’ve got financial counselors that work there that can help the individual sort of navigate from their benefits," Turner said.

"We can tell you how much your out of pocket cost is going to be but that's very much a one-on-one right now," Calhoun said.

Calhoun provided me with an example.

"It will be like if your car insurance included oil changes and car washes you would be sure to use those programs," Calhoun said.

Turner said this creates some complications since different healthcare institutions have different pricing practices.

"A good example might be room and board charges. One facility might include all of the supply cost that are associated with that stay and their room and board. Another might individually bill for those supplies," Turner said.

Calhoun and Turner tell KSFY News that the easiest way to estimate out of pocket expenses is to utilize resources that the hospital has to offer.

"This is really going to be a catalyst for consumers to be more sensitive about healthcare costs," Calhoun said.

Consumers are seeing more and more of their household budgets every month being taken up by healthcare costs.

Pricing estimates are now available on both Avera and Sanford's websites.

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