New law requires transparency in healthcare pricing

On Jan. 1, 2019, hospitals in Delaware and across the country were required to provide prices for services to the public and potential consumers.

The transparency law, under the Affordable Care Act and supported by Congress, requires hospitals to list prices, also called chargemasters, for all the services they provide.

In Delaware, searching for patient prices by hospital usually starts at a webpage titled “Understanding Medical Costs” or “Understanding Hospital Fees.” From there, consumers can find a link to download patient service charges. That link, however, opens to a massive spreadsheet that requires a keen eye and a degree of medical understanding to find the price of a specific procedure.

Christiana Care Health System's website offers one of the easiest price transparency pages to navigate, but Beebe Healthcare's Sharon Kesterson, director of patient financial services, said Beebe is developing its own page to assist consumers.

“We met the minimum requirements in January, and we're in the process of getting a new website. In the near future, you'll see a much easier site to navigate,” she said. “We see this as an opportunity to be more patient friendly and customer focused because healthcare is not an easy industry to understand from a patient perspective.”

While Christiana lists costs for its top inpatient procedures and surgeries, Beebe and Bayhealth both use lengthy spreadsheets which make comparing prices difficult.

Kesterson said Beebe puts raw data on its spreadsheets, but the costs don't always compare with other hospitals.

“Just putting prices out there is not really benefiting the consumer as much as one thought it would,” she said.

Costs to deliver a baby – both vaginally and C-section – are comparable among the three hospitals, although Bayhealth lists a line item for delivery of placenta at $5,236 – a price that exceeds the cost to deliver a baby vaginally, which is listed at $3,922.

The line item for psychoses – unique because all three hospitals included the single-word description on their spreadsheets – showed a huge discrepancy in price. Christiana lists treatment cost at $17,509; Bayhealth $7,537; while Beebe is at $50,655.

Beebe Healthcare spokesman Ryan Marshall said the amount is based on 2018 costs, and there are outliers that could drive the number up.

“I cannot get specific without revealing confidential information, but looking at the data, it does correlate,” he said.

In other line-item comparisons, Kesterson said costs can differ depending on whether a procedure is inpatient or outpatient, and what other costs are bundled into the procedure. For example, in a joint replacement procedure, she said, the cost of a new joint can vary depending on the manufacturer, which can add to the overall cost.

“There are a lot of variations that make up the charges,” she said. “When you start looking at the spreadsheets, it is confusing.”

Kesterson said she has price-shopped herself for different procedures, and she hasn't found anything out of whack among Delaware hospital pricing. At Beebe, she said, the hospital has invested in software to compare prices in the area in order to stay within the market average.

For the best estimate on how much a procedure will cost, Kesterson said, all hospitals offer a patient financial service. The department not only takes into account total charges but how a person's insurance will factor in, she said, so a consumer can better understand their total out-of-pocket costs.

“That's where it gets more user-friendly for the consumer,” she said.

Bayhealth offers a price estimates team to help patients navigate their healthcare costs, said Danielle Pro-Hudson, media center coordinator for Bayhealth. “There are over 10,000 procedure codes with hundreds of updates to that code set each year,” she said. “To assist patients in identifying procedure and other associated costs, Bayhealth has created a price estimates team that provides patients with their estimated out-of-pocket costs for procedures and services.”

When the transparency law went into effect in January, Kesterson said Beebe had anticipated more public interest in costs.

“We really haven't had much response from the public. We were really gearing up to be able to answer a lot of questions from our community – from people asking about prices – but we may have had two or three calls. It really wasn't what we expected,” she said.

For patient costs at Beebe, call 302-645-3546. For patient costs at Bayhealth, call 302-310-8001 or email Price_Estimates@Bayhealth.org.