Two years after federal rules first required hospitals to share what they charge for different services, a report suggests only 15 percent of Kansas hospitals have hit the mark.
Consumer group Patient Rights Advocate’s February report found that three of the 20 hospital systems it reviews in the state — the organization focused on the largest hospital systems — fully comply with the federal price transparency rule. The group said many on the list were partially compliant.
“We can count on what will be charged for milk, or even eggs. We know that eggs have increased due to supply and demand. But we’ll know what those prices are,” said Cynthia Fisher, founder of Patient Rights Advocate. “It’s not like you find out how much a dozen eggs cost, weeks or months later, and it’s 100 times more than you ever expected.”
The group’s report looked at 2,000 hospitals nationwide and focused on the country’s broader health systems. The nationwide 25 percent rate of compliant hospitals, according to the group’s accounting, is nearly double that found in Kansas.
“We applaud those hospitals that fully publish all of their prices,” Fisher said. “However, this shows that other major hospitals in Kansas are breaking the law.”
The report strongly conflicts with more limited sampling conducted by the federal Centers for Medicare and Medicaid Services. The government agency released a report this month that said 70 percent of the 600 hospitals it surveyed met the website’s evaluation criteria. They include machine-readable files and easy-to-use displays as a price estimating tool. This marked a 27% improvement over what CMS found a year ago.
The Patients Right Advocate report shows that Centura Health, which operates two locations of St. Catherine’s Hospital in western Kansas, fell short of federal rules. That hospital group disputed the findings.
“We encourage our patients to request a patient-specific quote to help them determine their costs,” the organization said in a statement. “In addition, Centura Health and our 19 hospitals comply with the federal Price Transparency Act.”
Mercy Hospital in Columbus was also listed as non-compliant, but officials say it has met all CMS requirements.
“CMS determines hospitals’ compliance with these regulations, and while political groups continue to ask for new rules and regulations, they do not set requirements,” a hospital spokesperson said in a statement. “We stand behind our transparency efforts, which are supported by the fact that we acted quickly to correct a single request raised by CMS in 2021. We would do the same if CMS had other concerns.”
Turquoise Health collects data from hospitals and ranks it based on pricing transparency. It gives five out of five stars to St. Catherine-Garden City Hospital in Centura and two out of five stars to Mercy Hospital in Columbus. The St. Catherine-Dodge town of Centura does not have a scorecard.
Even when hospitals share numbers, it can be confusing. A recent analysis by the Kaiser Family Foundation found that hospitals are inconsistent with the organization of files and where price transparency data is located on the website.
“Even if there was a specific condition that the patient is trying to score on, there are many times that key information is missing from the data,” said co-author Krutika Amin. “And when the data is available to the patient, it might be difficult to figure out what all the different pieces go into in the service they’re looking for.”
Amin said that to get a true estimate for a medical bill, it may be necessary to combine costs listed individually online.
“It may take some maneuvering for even an expert to put together the pieces that make up the costs for care,” he said.
The missing codes can also make it difficult to know the difference in charging between inpatient and outpatient settings, Amin said.
Fisher, the founder of Patient Rights Advocate, said CMS needs to enforce its rules more aggressively. The federal agency sent warning letters to about 500 hospitals but fined only two hospitals, both in Georgia in 2022. The two became compliant after being fined.
Starting this year, the Biden administration increased possible fines for non-compliance. They range from $300 to $5,500 a day.
Fisher said the first step in addressing high healthcare costs is to have hospitals disclose prices that are easy for consumers to read.
“The only way to get there is to be able to see the wide variety of prices that are there now and see comparatively what’s happening in the state of Kansas on prices,” he said, “and how that compares to adjacent states.” . “