Should Hospital Charges Be More Transparent?

Should Hospital Charges Be More Transparent?

A couple of recent efforts to increase pricing transparency in California hospitals have stalled. We asked stakeholders whether the public should have more access to hospital prices.

Consumers are getting new tools for comparison shopping in some areas of health care, but not all.

Part of the Affordable Care Act calls for side-by-side comparisons of health insurance policies. New features on HealthReform.gov allow consumers to compare insurance costs, services and other policy details online.

Several websites offer information, grading and comparisons of physicians.

Consumers have online tools to compare hospital quality, patient satisfaction and safety, but not to compare hospital prices.

The cost of a hospital stay for privately insured patients in California has risen by an average of 8.5% a year over the past five years, according to state records. The cost of outpatient visits has gone up by 9.6% a year.

Nationally, over the past decade, hospital prices have risen by an average of 4.9% a year for individuals with private insurance, according to data from the federal Bureau of Labor Statistics.

A couple of recent efforts to increase pricing transparency in California hospitals have been thwarted.

Some hospital charges for specific services must be revealed under state law, but the law does not require hospitals to divulge negotiated prices, which can be substantially different than reported prices. A bill, AB 2389 by Assembly member Ted Gaines (R-Roseville), to ban hospitals from including “gag clauses” in their contracts that forbid insurers from revealing differences in costs and quality among hospitals in their network passed both houses but was sent to the Assembly’s inactive file on the last day of the session, effectively shelving the issue.

For four years, two large, influential purchasers of health care — CalPERS and the Pacific Business Group on Health — have waged a campaign to get California hospitals to participate in the creation of a statewide data system to compare both hospital quality and prices. California hospitals argued that public airing of prices would be anticompetitive.

The CalPERS/PBGH effort appears to have stalled.

We asked stakeholders: Where should California go from here? Should California hospital financial information be more transparent? If so, how should data be collected and displayed?

We got responses from:

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