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SALT LAKE CITY — For years, patients trying to estimate the cost of their medical care may have felt they were putting together a million-piece puzzle, without a picture to guide them.
Starting Jan. 1, 2019, the Trump administration hoped to solve that. The government required hospitals to post their standard price lists online.
All major Utah hospitals have complied with the rule. Just how useful they are is up for debate.
Pricing medical care
“It still doesn’t seem real,” said expectant mother Taylor Wynn.
Wynn is halfway through her first pregnancy. She and her husband are both busy picking up extra shifts at work to sock away money.
“So that when the baby gets here, we’re not overwhelmed,” said Wynn. “I kind of expect it to be like $8,000 to $15,000.”
The government’s new price disclosure rule is supposed to make planning for medical costs easier. But when KSL tried to find the information on the websites of the three major hospital groups in Utah: Intermountain Healthcare, MountainStar Healthcare, and the University of Utah Health system, the information was often difficult to find, and difficult to use.
Links to the chargemaster price lists are at the bottom of most hospital webpages and require some persistence to find. Once downloaded, the lists are very technical, and may be difficult for most consumers to understand, with descriptions such as “NIPT FETAL ANEUPLOIDY W/ MICRODELETION.”
“I know a pretty decent amount about medical billing and coding, but this isn’t something where I could go in and predict what was going to happen or what was going to be charged,” said health care advocate Whitney Duhaime.
Duhaime helps lead a firm that battles insurers over a patient’s medical bills. She said the price lists don’t help much for estimating the cost of a procedure, because unlike a new coat, or a hamburger, a patient’s real cost is actually kept secret.
“Insurance companies will usually negotiate prices with the hospital. So the hospitals and insurance companies are always negotiating, and that is not public information,” said Duhaime.
Better cost tools
The hospitals know this information is complicated. In fact, they all suggested using better resources they’ve had on their websites for years.
MountainStar has posted its average prices for common procedures since 2007.
Intermountain has a tool for SelectHealth members to estimate their costs>.
The University of Utah Health System also created its own online cost estimator.
Kathy Delis, the Revenue Cycle Support Service Director for University Health, helped create the tool four years ago.
“We really wanted to make price estimates meaningful for patients,” said Delis.
The online tool uses a patient’s insurance information, medical procedure cost, and doctors’ fees to spit out a more complete estimate of the cost of care.
Delis said it’s much more comprehensive than what someone trying to calculate their cost using the standard price lists could come up with.
“This really does give you your full cost of care,” said Delis.
Utah PricePoint system
The state of Utah has also kept track of average hospital prices for years using discharge data. All three major hospital groups send information to the state, which is available to consumers online.
KSL had Wynn try it out, and the results surprised her. Her estimate showed it may cost $1,000 less to deliver her daughter at American Fork Hospital rather than Utah Valley Hospital.
“It legitimately might have changed, like, where I delivered and like what doctor I went to,” said Wynn.
She said if she was aware of the difference 20 weeks ago, she might have chosen to deliver her baby at Utah Valley Hospital instead.
“It’s not the bottom line but it is a factor in your decision making,” said Wynn. “I had no idea that this even existed and that would have been helpful.”
While the standard price lists now required by the government may not be useful for determining exactly what you will pay on your next visit to the hospital, they could help you decipher your medical bills.
You can compare your bill against the price list to spot billing errors.