10/11 NOW Investigation: Price transparency at Lincoln hospitals
LINCOLN, Neb. (KOLN) - For decades, there’s been a lot of unknowns about how much medical care will cost, sometimes not knowing what will be owed until after the bill comes. A 2021 law federal law aimed at changing that by requiring hospitals to put out a detailed list of prices right on their websites. Now, a year into that new law, 10/11 NOW wanted to find out if Lincoln hospitals were complying.
Both Bryan Health and CHI Health told 10/11 NOW they’ve been compliant since the law went into effect in January of 2021. The law requires hospitals to post machine-readable spreadsheets that list prices of care for all procedures, for all forms of payment. A link to an excel spreadsheet was found on CHI Health St. Elizabeth’s website, along with a price-estimator tool.
“Trying to provide as much information as possible for a service so people can know what might be owed before care is important,” Jeannette Wojtalewicz, Chief Financial Officer for CHI Health said.
Bryan Health’s site links to a text file, which 10/11 NOW found harder to navigate, but provided the same information, and does comply with the law.
The documents are supposed to contain the following information: codes, gross charges, discounted cash price, negotiated minimum, negotiated maximum, negotiated rates and payer and plan for every health insurance company the hospital contracts with. This is where the group Patient Rights Advocate said CHI and Bryan aren’t compliant.
“Their files are incomplete,” Cynthia Fisher, with Patient Rights Advocate said. “Every CEO of all hospitals who aren’t complying are doing financial harm to the patients they’re trying to serve.”
Based on 10/11 NOW’s review of the sites, most of the information required by law is available on both sites. A second organization, Turquoise Health, found Bryan Health was missing just a few key pieces of information.
“If we could ever find out what we’re missing, we’d be the first ones to put it out there,” Tim Meier, Senior Director of Revenue Cycle said.
Both spreadsheets did have blank boxes or prices listed as N/A. CHI said that is because there aren’t standard set prices and Bryan said it’s because many medical costs are lumped into flat costs associated with specific diagnoses.
These intricacies are why the hospital systems said patients shouldn’t base their entire price estimate on these documents alone. Both recommend patients also go through their respective price estimator tool online. The tool allows patients to put in their insurance information, pick the procedure they’re getting and see an exact cost.
As for how to use it, both have some advice.
“Start with your physician,” Wojtalewicz said. “There’s a lot of details around each procedure. If a patient needs an MRI, for example, is it of the head, of the neck, with contrast, without contrast. As about your specific procedure then go to the tool, go to the spreadsheets or get the cost estimate specific to them.”
Meier recommends patients skip the spreadsheets altogether.
“It’s intended for third parties and apps and other things to compare prices across hospitals,” Meier said.
He said putting in insurance information into the price estimator tool is the best way to get an accurate picture.
“If you do have insurance we will go out and ping your insurance and tell you here is what we know right now is actually left on your deductible and co-insurance that you owe,” Meier said.
The both also said it’s important to remember these numbers are just estimates.
“Let’s say a patient needs surgery and it’s going to be a gallbladder removal,” Wojtalewicz said. “That’s what’s anticipated but once you open them up and find complications procedures can change, estimates can change.”
Here’s a list of links to help patients check prices:
CHI Health Price Transparency Spreadsheets : https://www.chihealth.com/en/patients-visitors/price-transparency/standard-charges.html
CHI Health Price Estimator Tool : https://www.chihealth.com/en/patients-visitors/cost-estimator.html
Bryan Health Price Transparency Spreadsheets : https://www.bryanhealth.com/app/files/public/9445db63-f1a5-4934-9ab9-db5268380130/BMC%20Pricing%20Transparency%20File%2006-17-21.txt
Bryan Health Price Estimator Tool : https://mychart.bryanhealth.org/MyChart/GuestEstimates/AcceptDisclaimer?svcArea=WP-24BAtkFMaiA3K7FGPPYvAAXA-3D-3D-24eTBx3jHFx9lKuqXroXQ3ZVgA7-2Fk5NLZUTqAB2JmQAvU-3D&isMultiSA=False&location=WP-244gAb1INa08R8El-2BjAizBMw-3D-3D-24TwE3HlJlMi6Kq3gYfs2fyUdnxVIKLxGLYisHPKLdnL8-3D
Patient Rights Advocate Report : https://www.patientrightsadvocate.org/
Bryan Health patients can also call 402-481-4900 for an estimate.
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