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SALT LAKE CITY — A Utah lawmaker is looking to shine a light on the complicated world of health care costs by proposing that hospitals and doctors be required to post the price of common procedures.
“Doctors really don’t even know what the cash price is,” said Rep. Brad Daw, R-Orem.
Daw said he has opened a bill file for the 2019 session and that legislation is currently being drafted that would give Utahns the ability to shop around before they go to the doctor.
“They would be able to go to a website, type in that procedure and get a listing of what different providers charge for it and also an indicator of quality,” he said.
Daw’s proposal comes as a KSL Unaffordable Utah report showed how even the experts can’t figure out why hospitals charge what they do and that knowing the fair price is essential when bargaining with providers.
“The basis of advocacy is knowledge,” said Whitney Duhaime, vice president of Denials Management in Salt Lake City.
Duhaime’s company negotiates insurance claims and said there’s no rhyme or reason to what’s billed by a provider and what’s paid by insurance companies.
“Health insurance companies, they do not have to produce their fee schedule,” she said. “We don’t know why they pay what they pay. We don’t know what they base it off of.”
Publicly displaying the names of procedures and the associated price, Daw said, would also put pressure on those medical providers charging more than the normal range.
You get this medical bill and it’s four times what you thought it was going to be and you have no idea why and you can’t go online and figure out why.
–Courtney Bullard, Utah Health Policy Project
“We hope to see that prices would tend to come down as consumers become more aware of better deals,” he said.
Daw is working with health advocacy groups to research best practices and see how other states are providing cost transparency in the health care industry.
“Cost is just disproportionately getting higher and that’s something that in Utah we’re really, really concerned about,” said Courtney Bullard with the Utah Health Policy Project.
Bullard said as medical costs climb, it’s becoming more important for patients to have the information they need to make informed decisions.
“You get this medical bill and it’s four times what you thought it was going to be and you have no idea why,” she said, “and you can’t go online and figure out why.”
Bullard said if patients know they cost beforehand, they can plan ahead and also have a reference point to question bills that seem too large.
“We want to make sure that when a consumer’s going to the hospital they know what they are getting into,” Bullard said.
Colorado’s Transparency in Health Care Prices Act, which went into effect at the beginning of this year, requires that health care providers disclose what they charge a self-pay patient for common health care services.
Such an approach could help the nearly 12 percent of Utahns who don’t have health insurance. According to the Gallup-Sharecare Well-Being Index, Utah was among 17 states that had meaningful increases in the uninsured rate.
In 2016, 9.7 percent of Utah residents went without health insurance. In 2017, that group grew to 11.8 percent, the Gallup poll showed.