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New law helps empower the patient

| January 13, 2019 4:00 AM

On Thursday we reported on a new federal law that took effect Jan. 1 requiring hospitals across the U.S. to publish online price lists for all of their medical services. Ultimately, the Centers for Medicare and Medicaid Services hopes this change will bring about a transition of power favoring the consumer and provide a more patient-centered health-care system.

For too long, the actual costs of health care have been cloaked from the patient. We can’t think of another industry where the cost to the consumer is unknown until after services have been purchased. Retailers put their prices right out front so shoppers can compare costs. Utilities give us a price per kilowatt-hour or gallon. Even car mechanics can accurately price out the cost to install a new alternator before performing the work.

Why should health care be any different?

To be sure, health care isn’t as black and white as shopping at Walmart — out-of-pocket costs can be influenced by different types of insurance and a person’s income, and procedures can vary from one patient to the next. But we believe this new law brought forward by the Trump administration is a move in the right direction.

Still, there is much work to be done.

Many of these online charge masters are far from user-friendly for the lay person, and some officials worry that poorly executed cost sheets will only add to the confusion.

Kalispell Regional Healthcare’s price list is organized by “charge codes” and ambiguous descriptions with wildly varying charge amounts. For example, there are 19 line items listed under the description “cardiology,” ranging from $462 to $6,124. What exactly does “cardiology” entail? The consumer wouldn’t have a clue through this price list.

Bozeman Health’s charge master is even less helpful. One entry under cardiology is described as “ENDOLUMINAL IMAG IVUS/OCT INITIAL COR GRFT.” Whatever that is, it costs about $1,000.

Credit Whitefish’s North Valley Hospital for being ahead of the curve in providing a friendly online portal for price transparency. Their charge master has procedures mostly written in layman’s terms and organized by body systems. Comparative charges are displayed side by side as median, low and high costs. It’s clear that Montana’s other hospitals should follow North Valley’s lead in this arena.

The Centers for Medicare and Medicaid Services readily admits this new law isn’t perfect, nor the end game.

“We know this is just a first step, and we have actively sought input on how we can make this data easier for patients to use,” said Seema Verma, administrator of the Centers for Medicare and Medicaid Services.

Hopefully this “first step” ultimately leads to a running stride in the fight for price transparency and empowering the patient.