Hospitals Begin Posting Prices on Websites

January 9, 2019 6:26 pm

A new rule regarding hospital price transparency took effect with the New Year, but the ultimate costs to patients and insurers are different from charge data.

In response to the CMS rule requiring all providers to publicize pricing for hospital services, Mercy Health hospital websites contains pricing information on every charge in spreadsheet format. This is the direct link to Mercy Health hospital charges.

Mercy Health hospitals have been providing consumers with online information about price estimates for the past several years. With the new CMS rule, these web pages were updated to include the charges for each procedure.

While the requirement makes pricing more transparent, there is a lot of confusion about what patients and payers actually pay. The ultimate costs to patients and/or their insurers are quite different from charges.

“Charges” are the dollar amounts a care provider sets for services before negotiating any discounts for payers. The amounts that are actually paid to the hospital by insurers and consumers are quite different. Charge numbers reflect bundled services associated with specific procedures and they are based on a number of variable factors including length of stay, pre-existing conditions, potential surgical complications and resources used.

Looking at charge master numbers is not the same as actual patient out-of-pocket estimates, so it is important that consumers reach out with their questions. Our web page provides the contact information for each of our Mercy Health hospitals.

Ultimately, the prices consumers pay for services depends on their health insurance, the networks their insurers participate in, and the number and status of providers who get involved with their care.

Questions consumer may ask:

Why are we posting charges on the Internet?
The new CMS price transparency rule requires hospitals to make a list of their current standard charges available on the internet.

Charge data is required to be posted in machine-readable format (CSV).

Data must be posted by 1/1/2019.

Are the prices online for Mercy Health hospitals?

Mercy Health and all Trinity Health hospitals are compliant with the new rule. Our hospital website includes a link to the charges.

What do the charges mean? Is this what I have to pay?
The ultimate costs to patients and/or their insurers are different from charges.

  • A charge represents the dollar amount assigned to specific medical services before any negotiated discounts to third-party payers are applied.
  • Actual hospital charges will vary based on the type of care provided, treatments, individual health conditions and other factors.

How do I find out what my out-of-pocket price estimates might be?
Out-of-pocket patient expense estimates are available. Our hospital website features information on how to obtain estimates.

How does this information help consumers?
Price transparency supports informed decision-making. Although hospital charges won’t be the exact price in most cases, they could make hospital pricing easier to understand.

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