What the New Hospital Price Transparency Rule Means For You


What the New Hospital Price Transparency Rule Means For You

February 22, 2019 Written by: Costectomy

Starting from January 1st, 2019, the Centers for Medicare and Medicaid Services (CMS) have required all hospitals to publicly display prices for all their services. This pricing list, called a “charge-master” sheet, is online-accessible, machine-readable, and includes all items and services provided by the hospital.

So what does this rule mean for you as a patient?

Well, now you can see the established charge-master prices for all the healthcare services at any hospital. By implementing this regulation, CMS hopes to increase cost transparency, patient-friendly communication, and increased healthcare choice.

In a statement, the agency said, “CMS encourages hospitals to undertake efforts to engage in consumer friendly communication of their charges to help patients understand what their potential financial liability might be for services at the hospital…”

Increased price transparency at all hospitals? That’s good news, right? For the most part – yes!

Steps like these help you as a patient be a more active healthcare consumer. However, there are some practical points you should be aware of before looking up hospital charge-master pricing sheets:

  1. Charge-master prices do not show bundled prices. In other words, each service you may require for one hospital visit will have a separate price. For example, if you go in for a surgery, the prices for anesthesia, pre-operative tests (x-rays, blood-work, etc.), surgeon’s fees, hospital fees, and post-operative care are all different services. You’d; have to look up at least five different prices. This may prove challenging and be slightly confusing.
  2. Similarly, medical care services are often coded, titled differently, or may have different levels of pricing for a service. This also makes the charge-master difficult for patients to navigate.
  3. The amount the hospital bills may not reflect the prices listed on the charge-master. The cost of each medical service varies by individual and facility, as they take into account insurance, financial assistance, and the hospital charity care policy. Employers or insurance companies may have negotiated discounts with individual hospitals; the rule does not require hospitals to post these amounts.

Here at Costectomy, we believe in value-based care, bundled costs, and finalized price tags because of these exact complications. The price you see on our site should be the price you pay – without any confusion! Regardless, we applaud this new regulation as a positive step towards increased healthcare transparency across the nation!