Getting the Most out of the 2021 Government Hospital Price Transparency Rule

We have a right to know exactly how much medical care will cost, before the actual bill arrives. But can we rely on government regulations to protect us?

This seems like an obvious one: As healthcare consumers, we should have the right to know how much things are going to cost. Whether it’s critical emergency care or routine treatment, physicians and hospitals should be honest and up front about their prices, just like any other private business.

But that’s not how things have been going.

Even with the implementation of the 2021 Government Price Transparency rule, healthcare consumers are still getting grifted with shadowy pricing structures and hidden charges.

It’s time to start fighting back. Here’s a look at what we can do right away to reclaim this vital healthcare freedom.

Despite New Regulations, Hospitals are Still Hiding Their Prices

Starting on January 1st, 2021, American hospitals are now required to provide a list of their standard charges. This includes the rates that they negotiate with insurance companies, as well as any discounts they offer for cash-paying patients.

But surprise, surprise, healthcare facilities across the country are failing (or refusing) to comply.

Fortunately, some labor groups and state legislators are ready to pick up the baton and help out. In Colorado, for example, employers are banding together to negotiate with hospitals and insurance companies to drive prices down. And in California, there’s a push to create a new Office of Health Care Affordability [PDF] that will work to set limits on how much physicians and hospitals can charge.

If they’re smart, they’ll put some teeth into these negotiations that will result in stiff fines for anyone that doesn’t comply. But to be sure, it’s going to once again come down to the consumer to protect their inherent healthcare freedoms, including price transparency.

How to Shop for Healthcare: Demand Price Transparency at All Costs

The new government price transparency rule forces hospitals to publicly display their costs. Here are a few ways we can use this rule to our collective advantage:

1. Look up your local hospital’s pricing data. This information should be publicly available on their website, and it must include standard charges for at least 300 shoppable healthcare services. If this information is not easily available, call the hospital and ask for a copy.
2. Shop around for the best prices. Just like shopping for a TV or a new car, don’t expect prices to be even remotely the same from one place to another. If you know your medical needs, you should be able to find the best deal before you set foot in the hospital.
3. Research Cash Price Discounts. These discounts should also be publicly available along with the rest of their pricing data. These prices are often well below standard negotiated rates, and can save thousands of dollars over the course of a year.
4. Ask for the “Bundled Price”. The cost of a medical procedure or treatment is one thing, but when you add in any lab tests, anesthesia, radiology, or “facilities fees”, you could be on the hook for a lot more than you think.
5. Don’t Accept Estimates or Averages. You have a right to know the exact price you’ll be paying, down to the dime. You should not have to provide any personal information to see these prices.

Power to the Patients: An Art Project That’s Spreading Awareness of Price Transparency

As the price transparency movement gains momentum, it’s important that we do what we can to elevate the issue and increase awareness across the country.

Power to the Patients is an online art project that is dedicated to promoting a more just healthcare system. By downloading their artwork and posting it to social media, you can help drive positive change for everybody.

You can also empower friends and family to be better healthcare consumers by inviting them to subscribe to this newsletter, or visit our blog.

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

The HSA for America Maximize Your HSA Newsletter is published monthly and emailed to subscribers at no charge. Subscribe now to stay on top of the critical information you need to know about health insurance, healthshare plans and managing your finances to achieve financial security.