Hospital pricing information for specific medical services is now available online.
Effective Jan. 1, we will post our list of standard hospital charges on the internet, to comply with a new requirement from the Centers for Medicare & Medicaid Services (CMS). Though CMS issued this requirement to improve transparency around the cost of health care services, the charges listed are very different from the amount of money that patients may ultimately pay for care.
We are fully complying with the CMS requirement but also understand that, without context, the list of charges is confusing. We have provided the following FAQs to provide clarity around the charge list. In addition, specialists from our billing department are available at 1-319-384-6275 or toll-free at 1-866-452-8506 to answer any questions.
What is about to change regarding the transparency of hospital prices?
The Centers for Medicare & Medicaid Services (CMS) is requiring all U.S. hospitals to publish a list of current standard charges in a machine-readable format on the internet by Jan. 1, 2019. The requirement is part of an effort by CMS to inform people about how much a hospital would charge for a specific procedure, such as knee replacement, for example.
Why is CMS making that change?
The cost of health care services can vary widely, which can often be confusing for patients and their families. CMS has issued this requirement to help people make informed choices about their health care. While the goal is for patients to use the information published to compare costs of procedures among providers, that may still be difficult for patients without knowing the rates their insurance companies pay. The published information will not include reimbursement rates from insurance companies.
Where will the information be made available?
You will be able to download the list at uihc.org/hospital-services-and-charges.
Will there be a one-size-fits-all approach to each treatment/procedure, or will different options or ranges of complexity come into play?
There may be some variation between inpatient and outpatient charges. We will also continue to reference the Iowa Hospital Association’s (IHA) hospital website. The IHA shares our information, along with the basic charges from other Iowa hospitals, on its Iowa Hospital Charges Compare website, which allows you to compare typical hospital and clinic visit charges.
Will the final figure be a specific number or will it be a high and low range?
The list will include specific numbers. Because the costs to patients are based on their insurance plans and other relevant financial factors, these charges may not be reflective of what you will pay for your health care.
How technical will the language and naming be for treatments and procedures?
The language and naming will be the line item descriptions in the Chargemaster, which is technical language. However, this information will be in addition to the information we already provide. Specialists in our Patient Billing Service are available to answer questions that patients have about the cost of specific procedures. They are available Monday through Friday, 8 a.m. to 5 p.m., at 1-319-384-6275 or toll-free at 1-866-452-8506.
Should we assume that our approach may change over time as we learn more about users’ preferences and how other academic medical centers are approaching the mandate?
CMS will likely update its requirements, and we will address them. As we learn more about best practices following the implementation, we will also incorporate the lessons that we and our peers have learned to help us communicate the clearest information possible and help patients make informed choices about health care.