- Courtesy UC Health
- UCHealth offers estimates through its patient portal.
That’s partly because a number of factors — hospital, insurance plan, provider, type of procedure — make the costs of health care differ widely from person to person. Though legislators and advocates nationwide have pushed for increased transparency in recent years, hospital stakeholders have pushed back, arguing that listing “sticker prices” for procedures oversimplifies the process.
With a new online tool, UCHealth became one of the first hospital systems in the U.S. to show patients exactly what they can expect to pay for a given procedure. The tool allows the hospital system to use updated information from a patient’s insurance provider to determine individualized costs.
Patients can also select different hospitals to shop by location in the UCHealth system, which holds information for about 150 procedures so far, says Dan Weaver, UCHealth’s senior director of PR and communications.
UCHealth launched its new service shortly after the Centers for Medicare & Medicaid Services released its own, less-specific tool that shows average prices Medicare patients pay for procedures.
Also, the nonprofit Center for Improving Value in Health Care (CIVHC) recently released its “Shop for Care” tool, where patients can compare average prices for common procedures across Colorado. Though patients can’t see how much they’ll pay out of pocket, and physician fees aren’t included, still, says Cari Frank, CIVHC’s vice president of communication and marketing, it offers a good way to compare facilities.
“If you’re shopping around for care, it’s probably a better place to start with our tool to look at where you might want to go outside of the UCHealth system,” Frank says.
Financial transparency was also a topic of contention in the state Legislature this year. House Bill 1358, Health Care Charges Billing Required Disclosures, would have required health care facilities to, among other things: publish “self-pay” prices for procedures; send itemized bills that showed how much a patient’s insurer paid; and disclose whether providers participated in an individual’s health insurance plan.
Hospital stakeholders including the Colorado Hospital Association (CHA) opposed the bill, arguing that posting the “self-pay” costs, so-called sticker prices, could be misleading because insurance companies often negotiate prices lower, and each plan is different. The bill died in committee in April.
In contrast, the CHA thinks UCHealth’s new tool could be a model for other systems “both in Colorado and nationally,” says Julie Lonborg, CHA’s vice president of communications and media relations.
The system was built on the Epic Systems platform, Lonborg says, one of a handful of systems across the country that house patient health data. Other hospitals using that platform could theoretically build the same system with the proper financing and tech support.
But for David Silverstein, the chairman of Broken Healthcare, HB 1358’s main backer, even if every hospital adopted such a system, it wouldn’t provide enough transparency.
“Your bank wants to make it easy for you to go take money out of an ATM anywhere. Your hospital doesn’t want to make it easy for you to go see a doctor anywhere, the doctor of your choice,” Silverstein says. “If every system [replicates UCHealth’s tool], and they will all do it, it’s not really going to add that much value to the patient until the hospitals, the health care systems all allow their systems to talk to each other.”
Silverstein’s not giving up: His group is already lining up sponsors for similar legislation next year.