The federal government has put important information about hospital costs in the hands of customers, an acknowledgement of the high and unpredictable price of accessing health care. Though it is a step toward transparency, consumers will probably struggle to use it.
As of the beginning of this year, hospitals everywhere must now post lists that show how much they charge for services. Newly required by the U.S. Department of Health and Human Services, the rule is born from a part of the Affordable Care Act that asked hospitals to make information about their prices public.
Yet the lists each have thousands of entries and don't look the same hospital to hospital. And facilities are interpreting the new rule differently.
Matthew Lewis, a health economist and associate professor at Clemson University, said he doubted the information would be useful to the average patient. Hospitals have kept information about prices hard to access for a reason, he said.
"If they really had an interest in making this clear for patients, they could have done it a long time ago," Lewis said.
What you need to know
The newly available lists show charges hospitals bill for thousands of procedures, services and medications.
The "charges" patients can now see are likely to be much more than they will ultimately be asked to pay.
The figures are what the hospital will bill the patient or their insurance company. But insurers have special rates negotiated with hospitals, Lewis explained. And many patients without insurance will get a discount.
Also, the standard hospital prices often do not include physician fees because physicians often operate independently. They also won't factor in any difference in prices for in-network and out-of-network providers.
Hospitals have been cautious about publishing the information, expressing concern that it will confuse their customers. One facility in Aiken requires visitors to its website to check eight boxes, each an acknowledgement about the drawbacks of the information, before it allows the user to download the price list.
Jana Pye, spokeswoman for Carolina Pines Regional Medical Center in Hartsville, warned in a statement the charge information won't show what a hospital will actually be paid. She recommended patients not try to use it to estimate what their care will cost. Carolina Pines, and many other hospitals, will help customers with a price estimate if they call. Still, Pye said price transparency should be a priority for hospitals.
"As patients take on greater responsibility for the cost of their care, hospitals have a responsibility to communicate with patients on what they personally will pay for health care services," Pye said.
Two hospitals in the state appear to not be following the rule yet, by The Post and Courier's review. A spokesman for The Regional Medical Center in Orangeburg said patients can call the hospital for an estimate. But he did not address why the list is absent from their website. A representative with Conway Medical Center said, "We're in the process of getting that posted." She also said there was no timeline to share about when they might make the list available.
More than two dozen hospitals in the state, including Roper St. Francis, have made their standard charges available on their websites. A handful of the hospital systems in the state also provided a second, even more helpful list of their charges, including the Medical University of South Carolina and Trident Health. A spokeswoman with MUSC said this extra information was also required, though some said the government ruling was more vague.
These lists have fewer than 1,000 entries — still a lot, but not as many. They are much easier to compare across systems because they average the charges by the kind of diagnosis.
Taking a closer look, a savvy consumer can stack hospitals' costs against each other using these lists. But higher charges at one facility won't necessarily equate to lower costs for some consumers.
What local hospitals might charge for ...
East Cooper Medical Center: $41,198
Trident Medical Center: $34,165
An allergic reaction
East Cooper Medical Center: $15,413
Trident Medical Center: $23,649
A chest pain diagnosis
East Cooper Medical Center: $25,254
Trident Medical Center: $29,927
East Cooper Medical Center: $42,591
Trident Medical Center: $57,917
Treatment for poisoning
East Cooper Medical Center: $24,588
Trident Medical Center: $38,348
Premature birth with major problems
East Cooper Medical Center: $118,220
Trident Medical Center: $40,072
How patients can manage health care costs
The S.C. Hospital Association has had a tool for a few years that might be easier for patients to use called PricePoint. Schipp Ames, spokesman for the hospital association, described the charge lists as a window into hospitals' internal pricing. If customers really want to try to use them, Ames suggested making ample use of Google to understand what the charges mean.
There might be simpler ways to manage health care costs, however. Making best use of an insurance plan is one of them.
Patti Embry-Tautenhan, spokeswoman for BlueCross BlueShield of South Carolina, said in a statement "we applaud the intent behind this effort." She said most people covered by BlueCross can use their online tool to estimate their cost of care.
Embry-Tautenhan pointed out all of this information being available only matters if patients use it before going to the hospital. And they should try to understand their benefits as much as possible. Ensuring professionals you see are in-network and knowing what your co-insurance payment and deductibles are will be key to avoiding surprising out-of-pocket costs.
Hospitals also have hotlines and experts on-hand to field customer concerns. Rod Whiting, spokesman for Trident Health, said the company makes financial counselors available to help patients understand what they will need to pay.
"The out-of-pocket amount that patients pay most often has more to do with their insurance coverage than the hospital’s charges," he said in a statement. "Patients appreciate having this information available early in the process.”
It may also be easier to choose a hospital by category.
There are three basic types of hospitals: government-owned, nonprofit and private. Drilling down on the data available paints a clear picture: Government-owned hospitals in this state are cheaper and care for more patients without insurance.
Using a tool developed by the hospital association, The Post and Courier reviewed hospitals' average charges. They show government-owned hospitals in South Carolina tend to be cheapest. They also care for more people without insurance.
The average charges at hospitals for two common problems
|Hospital's ownership||Percent of their patients without insurance||Charges, per day, for patient with pneumonia||Charges, per day, for patient with heart failure|
Yet costs are only one consideration. Most patients want to know they will receive high-quality care, and that may be even harder to estimate.
"The value of your health is superseded by nothing," Ames said.