EHP Blog

FINDING PRICE ESTIMATES ON A HOSPITAL WEBSITE,,,GOOD LUCK Only 20% of the Hospitals Received an A Grade. Find Out Who They Are!

 CMS has mandated healthcare providers to publish 300 services and the associated payments they receive from insurance companies on January 1, 2021.  This information will give healthcare consumers an insight as to how much insurance companies pay providers.  Most likely, this information will be published on their websites.

The Team at Healthcare Consumer Navigator Center (HCNC) wanted to know how easy or hard it is to navigate and find this information on providers current websites.  The primary goal was to locate pricing information and secondarily to validate the following:

Ease of Use and Number of Steps required to find price    information as well as availability

Price Information Available Real Time or Call Provider for the Price

  Consumer Financial Policies

  Provider Contact Information

   Quality Data and,

   Charge Description Master

The HCNC Team identified 15 hospital providers throughout the country that rated as one of the top 5 facilities within their metropolitan area. Most facilities had multiple locations, surgical centers, outpatient centers and multiple physician practices. Conventional wisdom would lead you to believe that these high-profile facilities would have easy to use websites and real time information available.  You be the judge.

The following is a recap of the study:

  • Ease of Use; Number of Steps/Clicks required to find price information.

 Average Number of steps/clicks to locatePricing6.6 steps/clicks on the average with a low of 4 and high of 15.

This assumes you were lucky enough to find it on the first try.       Add many more; 7-10 steps/clicks if you were not lucky.  Adding more is the usual process.  Most consumer do not have a clue were to start on the providers home page.

HINT:  ON THE HOME PAGE, LOOK FOR “PATIENT AND VISTORS” OR SOMETHING SIMILIAR; CLICK ON IT AND IT SHOULD TAKE YOU TO PATIENT INFORMATION.

  • Price Information Available Real Time or Call Provider

Only five (5) providers. 33%, had real time pricing using the consumers’ insurance plan and 67% required the consumer to call the facility.

HINT: MAKE SURE WHEN YOU CALL THE FACILITY YOU HAVE ASK YOUR PHYSICIAN IF THE TEST/PROCEDURE REQUIRES PRE-CERTIFICATION AND HAVE THE FOLLOWING IN FRONT OF YOU:

            YOUR INSURANCE CARD

A COPY OF THE PHYSIAN ORDER WITH THE NAME OF TEST/PROCEDURE AND HCPCS (HEALTHCARE COMMON PROCEDURE CODING SYSTEM) CODES.

  • Consumer Financial Policies

All providers had copies of various polices and procedure available and information to call the provider with additional questions.

HINT:  MOST OF THE POLICES AND PROCEDURES THAT WERE AVAILABLE WERE INFORMATIVE AND HELPFUL TO THE CONSUMER.

  • Provider Contact Information    

All providers had telephone numbers of the various departments the consumer would need.

HINT:  IF YOU ARE LOOKING FOR A PRICE AND WHAT YOU WOULD BE REQUIRED TO PAY, MOST PROVIDERS HAD A SPECFIC TELEPHONE NUMBER TO CALL.

  • Quality Data Available

Only four (4) providers 26% had quality information available and  74% did not.

HINT:  THE QUALITY DATA THAT WAS AVAIALBLE WAS LIMITED OR REFERRRED THE CONSUMER TO AN EXTERNAL WEBSITE.

  • Charge Description Master Available

Twelve (12) providers 80% had Charge Description Masters available, 20% did not.

HINT:  CMS REGULATIONS REQUIRE HOSPITAL PROVIDERS TO HAVE AVAILABLE THEIR CHARGE DESCRIPTION MASTER AS OF 1/1/2020.  THE CHARGE DESCRITION MASTERS WERE VERY DIFFEICULT TO FIND ON TH WEBSITES.  IT IS POSSIBLE THAT THE 20% THAT WERE NOT FOUND COULD BE ON THE SITE BUT WERE NOT FOUND.

  • Provider Scores

The HCNC Team develop a scoring system for each provider website.  Categories 1-6 above have a potential point score of 0-5, with a total score of 30 possible points.  The team rated each provider as objectively as possible.  The following is a summary of the scores:

30-25                    3                      20%                A

24-20                    7                      47%                B

19-15                    5                      33%                C         

14 and Below     0

Conclusion

As we asked earlier: “You Be The Judge”.  If these facilities are designated as the premier facilities in their respective metropolitan areas, healthcare consumers may have a long wait to see improvements.   With only 20% of the facilities receiving a A, one would like to think the scores would be higher.  It is clear, consumers will continue to struggle navigating the healthcare maze.

After Thought

The HCNC Team is letting you know which hospitals were included in the review. We mentioned these are highly rated organizations in their metropolitan area. We believe they are. 

Also included are the plaintiffs in the lawsuit filed against Health and Human Services that are trying to block the publishing of the 300 services.  NOTE: The last three (3) plaintiffs in the lawsuit were hospitals.  I would suggest you review their websites; “You Be The Judge; Good or Bad”

Hospital Providers Included In the Review

                             Baylor Scott and White Medical Center; Grapevine, Texas

                             Wellstar Atlanta Medical Center; Atlanta, Georgia

                             Emory University Hospital; Atlanta, Georgia

                             Northwestern Memorial Hospital; Chicago, Illinois

                             Baptist Hospital of Miami; Miami, Florida

Tampa General Hospital; Tampa, Florida

                             Cedar Sinai Medical Center, Los Angeles, California

                             UC San Francisco Medical Center; San Francisco, California

                             Hoag Memorial Hospital Presbyterian; New Port Beach, California

                             New York Presbyterian Hospital; New York, New York

                             Cleveland, Clinic, Cleveland, Ohio

                             Mayo Clinic, Rochester, Minnesota TOP 3…A SCORE

                             Virginia Mason Medical Ctr, Seattle, Washington TOP 3 A SCORE

                             Vanderbilt University Medical Center, Nashville, Tennessee

                             Porter Adventist Hospital; Denver, Colorado TOP 3 A SCORE

Plaintiffs in the Lawsuit filed against HHS

                             American Hospital Association

                             Association of Medical Colleges

                             Children’s Hospital Association

                             Federation of American Hospitals

Memorial Community Hospital and Health Systems; Blair, Nebraska

                             Providence Health System; Sothern California

                             Bothwell Regional Health System; Sedelia, Missouri

DISCLAIMER

  • The views expressed in this article are the authors’ alone and do not necessarily reflect our views.
  • The information contained in the article have been obtained from sources believed to be reliable.  We do not guarantee the accuracy, sufficiency or completeness of the information contained in the article.


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