Hospital Price Transparency Noncompliance

Janson Silvers  0:03  
Welcome to Healthcare Policy pop. I'm Janssen Silvers it's Tuesday, October 3 2023. Today's pop topics a deeper dive into hospital transparency, and why many health systems aren't following through. The no surprises act is aimed at taking the surprise out of health care bills. And a recent journal of the American Medical Association article says what you see should be what you get. But Jonathan Weiss, founder and CEO of health engine, a dynamic marketplace for health care services says that many hospitals aren't following transparency laws. One of the reasons is the lack of real penalties for non compliance.

Jonathan Weiss  0:43  
It's been a mix of non compliance by the health care providers themselves. That's down to really a lack of punitive regime that was first instituted, it's been since augmented, but the policing on this is just haphazard.

Janson Silvers  1:02  
Of course, many healthcare providers also don't make it an easy process for everyday patients.

Jonathan Weiss  1:07  
And these guys will often go to length in dumping a bunch of data that's not going to make sense even to a trained healthcare clinician, or claims and pricing expert for that matter. So I think there's a problem where patients aren't really aware of what they're facing. They think I have insurance. This is a network, they might not understand. I think there was a study done some years ago, only 5% of random individuals, consumers could tell you what a deductible coinsurance, copay and out of pocket limit even meant, and we're asking them to shop for something that's let's face it in a different language.

Janson Silvers  1:51  
Why says the complexity of the issues means the problem is multifaceted.

Jonathan Weiss  1:55  
It's a combination of unwillingness and intransigence by the provider side, and consumers who are still becoming aware of the possibility of engagement and what they may face. Well, after the fact,

Janson Silvers  2:12  
why says the real crux at the center of the hospital transparency debate is patients aren't the focus of healthcare anymore.

Jonathan Weiss  2:19  
A lot of the issue now is that the physicians and their practices are more and more being bought by the healthcare systems. And the incentive there is you now work for the system, you're going to make sure to keep the patient in this institution even if that's going to impact the patient financially on the negative side, even sometimes, clinically.

Janson Silvers  2:46  
Learn more about Jonathan Weiss and health engine by using the link in the show notes.

Janson Silvers  2:55  
A new secret shopper study underscores what y said in our interview, the study co authored by billionaire Mark Cuban found that hospitals are failing at price transparency for imaging services. According to the study, 60 diverse US hospitals were sampled. One example from the study among 47 hospitals providing prices for a brain MRI over the phone and online. 26% had discrepancies in the prices between the two of 50% or more. Less than 20% of the hospital quotes were the same online as they were over the phone, once again failing the patient when it comes to transparency. Finally, today, if you want to keep up with the financial penalties levied since the implementation of the no surprises act, there's a link in the show notes to do just that. The takeaway for patients rising now from the list is that although uptake has been slow, as we have outlined, the monetary penalties and the frequency of violators does seem to be increasing. Hopefully a sign that more enforcement is soon to come. That's all for today. We're back on Thursday for another health care policy pop, a resource of patients rising now. I'm Janssen Silvers, have a great day.