The Ongoing Battle for Medical Price Transparency

For too long, American hospitals have kept their prices a secret so that they don’t have to worry about the competition. But the fight for price transparency rages on, and ground is being gained.

Imagine that you’re out shopping for a new appliance. It’s something that your family desperately needs, like a new hot water heater. How would you make your choice? With dozens of models to choose from, how could you possibly know which one to buy? Maybe by color? Or which one is shiniest? 

The answer is, of course, the price tag. But now imagine that every appliance store in town got together and agreed to take the price tags off of all their products, insisting that they swipe your card now and send you the bill later. Would you hand the guy your credit card before knowing the price? 

This hypothetical retail dystopia may sound ridiculous, but that’s exactly how the American healthcare system has operated for years.

As discerning American consumers, we demand price transparency on the things that we want to buy. From TVs to new cars, we know how to compare prices across town and clench the better deals. 

So why aren’t we doing this with medical care? 

Hiding medical prices is wrong

The system has been operating this way for so long that it has become almost taboo to ask a doctor how much something is going to cost. But this is hardly the consumer’s fault. That’s because doctors and hospitals across the nation aren’t just being aloof. They’re taking intentional steps to obscure their prices, so it’s harder for people who need medical care to shop around.

The ongoing fight for price transparency

After a historic federal executive order in 2019, hospitals are now required to publicly disclose their standard charges. This includes specific charges for cash-paying patients, all of which must be made available in a single data file and accessible online. 

This was a huge step forward that is paving the way for further advancements. But with the strong (but expected) pushback from the hospital industry, this executive order is under threat of various legal challenges. 

But for now, hospital prices will start to become more competitive, particularly for discretionary services like X-rays, MRIs, and lab tests. It might also encourage hospitals to increase the number of elective services that can be done at outpatient clinics, reducing the cost for some basic surgeries by a significant amount. 

But the war is not over. In order to reclaim control of healthcare spending, consumers must step up to the plate when it comes to demanding transparency. 

What you can do to fight for price transparency

If we want to change the healthcare system in this country, it must begin with us. We have demanded transparency in all cases, whether it’s from a doctor, a provider, or even the legislature. 

Here are a few tools that can help in the fight:

• State-run price finders

Your home state might sponsor an online health insurance tool designed to help consumers make sense of local healthcare prices. For example, HealthScoreCT is a Connecticut based cost estimator that also features a medical provider rating system. 

The Sutter Health Estimation Tool serves users in the North Carolina Area, and Florida Health Price Finder is another example. Your Personal Benefits Manager can help you find something in your area. 

• Virgin Pulse / Healthcare  Bluebook

The strategic teamul of wellness technology company Virgin Pulse and Healthcare Bluebook has led to the expansion and proliferation of their popular Online Healthcare Shopping Solution. Simply type in your zip code and start comparing procedure costs in your area. 

• Don’t be afraid to ask for a price (Or a discount!)

Doctors and hospitals can be intimidating, but that’s how they want it to be. Don’t be afraid to ask your doctor or health professional about how much something is going to cost. Also ask if there is a cash-pay discount, and whether or not there are any other options for bringing down the price. In many cases, it’s possible to get an additional discount simply by asking for one.

Taking healthcare  control back from the hospitals and insurance company

It  shouldn’t be the consumer’s responsibility to seek out pricing information for medical care. Unfortunately, solving the healthcare crisis is going to take some serious effort from American healthcare consumers. 

Interested in learning about other ways to take control of your healthcare spending? Call your Personal Benefits Manager. We’ve got a number of consumer-driven options that help encourage a more active role in health spending. 

Call 800-913-0172 to set up a consultation, or check out our blog for more about consumer-driven healthcare. 

Click here to schedule an appointment, or call 800-913-0172 to get started.    

To your health and wealth,

Wiley P. Long, III
President - HSA for America

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