8 ms·
Hospitals release lists of retail prices for services
- adzm 8y agoWhat we really need is to make insurance coverages and deals public as well, for services and prescriptions.
- tehlike 8y agoOne step at a time.
- analog31 8y agoIndeed the entire ledger should be made public, so we see how prices vary depending on circumstances, and also, where the money is going.
- all2 8y agoWhat other for profit corporations do this?
- bmogen 8y agoWhat other for-profit corporations operate within the premise of improving public health and have multiple federal agencies overseeing their operations?
- all2 8y agoMy intent was not snarky, I actually would like to know if there are for-profit organizations that open their ledgers for regulatory purposes. I think its an interesting question, and there are implications if there is a precedent that health care organizations could follow.
- crankylinuxuser 8y agoInvestment banks do. In fact, it's how the SEC catches fraud and other foul play maneuvers.
- analog31 8y agoI would say, ones that are begging to be regulated more intensively. Disclaimer: I'd like to see the government generally begin to tighten the noose around the health care industry.
- kylec 8y agoNow that this information is public, I'm looking forward to the startups that will aggregate this info and let you cross-shop hospitals to get the lowest price, like for flights
- rocketpastsix 8y agoNot sure how that will be helpful if you are in the middle of a heart attack though.
- tehlike 8y agoIt will by means of fostering competition.
- orangecat 8y agoTrue, but emergency care is a much smaller portion of medical spending than many people realize: https://www.politifact.com/truth-o-meter/statements/2013/oct/28/nick-gillespie/does-emergency-care-account-just-2-percent-all-hea/ https://www.politifact.com/truth-o-meter/statements/2013/oct...
- dragonwriter 8y agoThat's emergency room care, but it's not like you're going to be shopping for care for most care provided in admissions from ER either (especially, e.g., ER -> ICU admissions.)
- chii 8y agoStill useful for other non-emergency cases. And also, you could pre-choose the hospital when you're healthy!
- jryan49 8y agoMaybe if the apps get good enough you just hit a button and it auto calls the cheapest hospital after a bidding war :)
- jtbayly 8y ago
- spsrich 8y agoSo it's not the first random number they pull out of their ass then ?
- tehlike 8y agoYou can still arrive at astronomical numbers by "combining" random number of procedures, or having random negotiated prices with insurances.
- kbsletten 8y agoI love the passive aggressive stab at Sutter. "Modern Healthcare decided to see how long it would take to present the data in a more consumer-friendly format. It took less than two hours - with a break for lunch - to create the 29 PDF files linked below."
- Forge36 8y agoThe requirement did state "machine readable". Arguably Sutter's data is the easiest to read, this is further evident through the creation of PDFs to make the data human readable so quickly
- AznHisoka 8y agoI agree. When i read that knock on Sutter, I thought it would be great if everyone released the data in JSON, making it easy to download, parse and compare! Let a third party build that useful price comparison tool - just provide the raw data.
- RHSeeger 8y agoI liked how they described it as "a blob of incomprehensible script.". It's JSON, which is a data format, not an incomprehensible script. If you're looking for a machine readable format, it's a pretty solid choice for this type of data on the web.
- nonbel 8y agoThose are not the real prices. Those are "chargemaster" prices, they are pretty much entirely irrelevant. The true price is usually going to be somewhere between 10-50% of the chargemaster: https://en.wikipedia.org/wiki/Chargemaster https://en.wikipedia.org/wiki/Chargemaster http://selfpaypatient.com/2014/01/03/insured-patients-can-save-money-by-pretending-to-be-uninsured/ http://selfpaypatient.com/2014/01/03/insured-patients-can-sa...
- all_blue_chucks 8y agoNonsense. These are the prices they charge people who lack insurance. They're very real if you get a bill with them on it.
- nonbel 8y agoI had a health issue and told them "no insurance", the prices dropped to nearly a third of what they would have been. So, it worked for me...
- jtbayly 8y agoNope. Those are the prices that they start with that your insurance claims they negotiated down to 50% or whatever on your bill from insurance for your copay. You can see the problem. Both the hospital and the insurance company are incentivized to keep that number artificially high.
- toomuchtodo 8y agoThey (hospitals, out of network specialists) are also under no obligation to negotiate with you. You are on the hook for whatever your insurance refuses to pay, which can be substantial regardless of what your deductible is. They might negotiate with you, but they might not, in which case you are at the mercy of whatever your state's creditor laws are. Florida? Great laws protecting your primary residence and wages from garnishment if you're head of household. Missouri? Not so much.
- 8y ago
- fxfan 8y agoWho is the secretary of health? I didn't see much of this on trumps twitter
- jfoutz 8y agoI haven’t looked in years, but the prices and regional modifications paid by Medicare were available. Check the docs for electronic submission. Maybe that’s been taken down? Always seemed like a reasonable place to start.
- refurb 8y agoThose are publicly available. And if you want a sense as to what the REAL prices are, those rates are pretty damn close.
- 40four 8y agoThis is very exciting to me. I have been wanting this for a long time, and I belive it's a small step towards improving the healthcare system in the United States. It shouldn't matter these aren't he "real" prices, as so many folks have been quick to point out. But it's the starting point for what ever you think the "real" price is, and it's information that has never been easily accessible to the public until now. A̶n̶d̶ ̶i̶t̶'̶s̶,̶ ̶m̶o̶s̶t̶ ̶c̶e̶r̶t̶a̶i̶n̶l̶y̶ ̶a̶ ̶r̶e̶a̶l̶ ̶p̶r̶i̶c̶e̶ ̶i̶f̶ ̶y̶o̶u̶ ̶h̶a̶v̶e̶ ̶n̶o̶ ̶i̶n̶s̶u̶r̶a̶n̶c̶e̶.̶ Maybe not? Some are saying this isn't always the case in certain instances We are all about markets in this country, so now it will be much easier to determine if a facilities prices are out of whack with its peers in it's local market. I don't know how much normal people will actually use this on a day to day, but I'd imagine this will open the door to some new services / products that could help regular people parse the data. I hate that people think this is a bad thing. The comment thread in the story about this trending here a couple weeks ago was so dissapointing. It makes sense to hear the hospital executives try to downplay or spin this in a negative light. I suspect some of them are nervous about what will be found... that some shenanigans might be exposed. I belive easy access to this data to be incredibly valuable. I think it's a win for regular people and the health of our markets. Just because it's not the price I pay after insurance doesn't make it misleading or irrelevant.
- nwhatt 8y agoWell said. In the Health IT community many have been quick to dismiss it as useless data, but data is data.
- dragonwriter 8y ago> but data is data. No, data that doesn't have any coherent practical meaning is worse than no data (well, it's worth exactly the same as no data if and only if you recognize the fact that it has no coherent practical meaning and disregard it entirely.) One of the classic bad-management failures is finding some easy to quantify it irrelevant to purpose number and optimizing around it because, hey, it may not be perfect “but data is data”.
- jtbayly 8y ago
- abalone 8y ago> Modern Healthcare decided to see how long it would take to present the data in a more consumer-friendly format. It took less than two hours Having been through several hundred thousand dollars of chargemaster charges with one of the hospitals on this list I can confidently say this info is not consumer-friendly at all. First of all, did anyone look at the damn PDFs? Do you have any idea what a "HCHG SP EVAL MTN FLUOR SWAL 75" is or a "HCHG XR RIBS BILAT W PA CXR"? Does this really equip the typical healthcare consumer with the ability to "shop 'n save"? No. They are going to ask their health insurance provider if the hospital is in network, and the health insurance bureaucracy has the experts who pour through and negotiate all this crap. Second, even if you had about a year of your life to educate yourself about the hundreds of myriad codes like this that are involved in various procedures and take it upon yourself to compare hospitals, this would be like comparing hotels based on their rack rate. You might get a sense for things but nobody pays that. Everything is negotiated down. Even for the uninsured who usually either get a 50%+ discount or pay whatever they can pay and kill their credit or go bankrupt. Which is not to imply in any way this is affordable for anyone, just that chargemasters aren't a super useful way to compare pricing even if you could figure it out. Third, it's a free market fantasy that more "consumer" info will fix this system. Many patients are not in a position to comparison shop anyway. It is the epitome of a market failure. If you want to fix this system we need Medicare For All.
- joshgel 8y agoI'm a doctor. I'm pretty sure I know what those things mean. But ya, wouldn't expect you to. Ultimately that's irrelevant, because you don't choose the services you get in a hospital, "I" do. If I come in and recommend this or that test, are you going to check the price? Of course not, because the issue is only partially hidden prices. Its also knowledge asymmetry and fear. I think most doctors only recommend tests they feel will be helpful and in my current position I have absolutely no incentive to order extra or unnecessary testing, so I try not to. I suspect (but I guess it hasn't been proven) that moving away from fee-for-service towards Medical Home type payments will resolve a lot of this as long as quality measures are carefully monitored and decreases in quality are appropriately sanctioned.
- 8y ago
- woogiewonka 8y agoIs anyone planning to scan all the available PDFs or data sources and put together a comprehensive tool for all hospitals in each state? Now THAT would be a hell of a tool to get hospitals scrambling to lower "not real" prices.
- ocrcustomserver 8y agoDoes a list of all hospitals (in each state) exist somewhere?
- ocrcustomserver 8y agoFound this: https://www.reddit.com/r/datasets/comments/4lxnjj/request_list_of_all_the_hospitals_in_the_us/d3vliej/ https://www.reddit.com/r/datasets/comments/4lxnjj/request_li...
- bmogen 8y agoThe startup that can take this data and hide it behind a UI that people use WHILE THEY'RE HEALTHY and then optimize care pathways before a health issue arises will be great (although probably not a great business).
- EamonnMR 8y agoThese are the stick that they threaten to beat the uninsured with to bargan with insurance companies. The entire process is ridiculous, and while they can hide behind whatever they want to say the "real" prices are, these are the threat. "I won't pull this trigger, I'll just wave it in your face until they empty the cash register."
- nonbel 8y agoYou've got it wrong. The uninsured don't pay these prices, the insurance companies don't pay them either. The people getting screwed are those who pay a deductible/co-pay based on the inflated prices, ie the people who pay for health insurance.
- dragonwriter 8y ago> The people getting screwed are those who pay a deductible/co-pay based on the inflated prices I.e., insured patients getting service from out of network providers; otherwise, if you have insurance, and you are paying deductible or co-insurance, it's based on the insurance negotiated price, not the chargemaster price. OTOH, if you are paying a co-pay, it's a flat fee in your insurance policy and the actual (chargemaster or negotiated) price is irrelevant.
- nonbel 8y agoYou sure about that? I am fairly certain I've read of cases where it made more sense to pay the uninsured rate (because uninsured rate is even less than the deductible). Eg, the chargemaster rate could be $10k and you have a $2k deductible but the uninsured rate is $1k: > "Because of the way insurance contracts are typically structured between providers and insurers, the provider is required to charge the full “negotiated” rate they and the insurer have agreed to, even though the patient is paying the entire bill themselves. This creates the odd situation where someone who is uninsured will get a better price than someone with insurance, even if both of them are paying the whole bill themselves." http://selfpaypatient.com/2014/01/03/insured-patients-can-save-money-by-pretending-to-be-uninsured/ http://selfpaypatient.com/2014/01/03/insured-patients-can-sa...
- nickpsecurity 8y agoAdam Ruins Everything has a skit on this for people who haven't heard of it: https://www.youtube.com/watch?v=CeDOQpfaUc8 https://www.youtube.com/watch?v=CeDOQpfaUc8 On one of my non-insured years, I did get a five-digit bill like one in the video. Then some more from a bunch of other companies. It shouldn't have been legal. Especially given I couldn't exactly shop around for better prices with them all faking them.
- curiousgal 8y agoI find this whole situation ironic because whenever I come across a news article online of some Third World country making an improvement, mostly in regards of human rights like Saudi Arabia allowing women to drive or Tunisia passing inheritance equality laws, the general response is "Meh, this shouldn't have been an issue to begin with". When it comes to the U.S., particularly with anything that involves its helathy care system, the slightest event is considered a step in the right direction. Well guess what? I wholeheartedly believe that it is both sad and pathetic to consider this as a win for the people against the healthcare industry. A country as rich as the U.S. and that spends on healthcare per capita more than other countries like Canada, should not have a for profit system. A "hospital's retail price list" is the epitome of a for profit system, those words shouldn't even be in the same sentence together. I understand that HN crowd is probably in the top 10% of the country so advocating for the system to change probably is of no concern to us, but let's not lie to people and say things are getting better when they clearly are not.
- cdoxsey 8y agoHealthcare systems are not uniform. Canada or the UK's system is quite different from other systems. For example the Netherlands has a hybrid system that utilizes a competitive, private, for-profit insurance market (with subsidies from the government). I think a lot of first-world countries have systems like that. (they aren't publicly managed, single-payer systems) And given the rhetoric on this issue I was very surprised to learn that. I agree that the US system is in need of major reform, but prices, competition and markets can be an important part of a healthcare system for price constraints, innovation, mitigating corruption, etc. As an example, consider food stamps, which helps people get food, but does so via the private market. The program would be a lot worse off if the Government decided to open grocery stores or tried to run the whole supply chain. Perhaps a similar line of reasoning applies to healthcare?
- splintercell 8y ago> For example the Netherlands has a hybrid system that utilizes a competitive, private, for-profit insurance market (with subsidies from the government). I am always skeptical of these claims. We have a hybrid system for higher education which utilizes a competitive, private, for-profit education market, with heavy subsidies from the govt (given to the students in the form of aid). Look what it looks like, ever increasing prices. Take our K-12 schooling system, again the same problem, somehow it works great for other racially homogenous European and Asian countries, but in America, we spend far more on public education per students, and get worse results. So why is the belief that our healthcare system is going to look like Netherland's when our education system doesn't look like that?
- nopinsight 8y agoStartup idea: Help (potential) patients compare approximate total prices of different hospitals based on the patient’s conditions, diagnoses, insurance plans (or lack thereof), personal health profile, etc. Display info as tables and charts in a user-friendly manner. Give users the option to drill down to see details. Update estimates as more information is known (e.g. after lab results come in). Support what-if scenarios for cases which diagnoses are still unclear.