The Evolution and Impact of Hospital Price Transparency in North Carolina

Ward, Christine; Reeder, Tim

doi:10.18043/ncm.81.2.95

Cited by 1 publication

(4 citation statements)

References 6 publications

(6 reference statements)

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“…Since the implementation of the CMS price transparency rule, several studies have attempted to compare chargemaster charges among institutions for fewer items over larger geographic areas. [24][25][26] One study looked at six advanced diagnostic imaging services across the top 20 ranked hospitals in U.S. News and World Report. 25 Another study analyzed lowdose chest CT scans for lung cancer screening across 55 American College of Radiology accredited imaging centers across the United States.…”

Section: Discussionmentioning

confidence: 99%

“…This accessibility is similar to the study of North Carolina chargemasters where only 72% (79/110) were accessible. 26 Chargemaster files often used ambiguous terminology and lacked a common standard to describe charges. This was seen in a prior study with 19 different descriptions for head CT without contrast across 20 hospitals.…”

Section: Chargemaster Accessibility and Usabilitymentioning

confidence: 99%

“…Although these specific price variations may not be generalizable to the rest of the United States, previous studies have identified high variation and prices across different items ranging from 56 to 4,916% difference across items and studies. [24][25][26] The study of chargemasters across North Carolina revealed a 358% variation across institutions ($72.00-258.00) for a complete blood count with differential. This price variation was not as extreme as was identified in our local market (1,375% variation, $48-708) for the same laboratory test.…”

Section: Chargemaster Charge Variationsmentioning

confidence: 99%

“…Hospitals have even been found to have disclaimers discouraging users from using chargemasters to calculate out-of-pocket costs. 26…”

Section: Failure To Achieve Price Transparencymentioning

confidence: 99%

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Survey of Hospital Chargemaster Transparency

et al. 2021

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Background In January 2019, the Centers for Medicare & Medicaid Services (CMS) required hospitals to list their standard charges (chargemasters) publicly in an effort to increase price transparency in health care. Surveying hospital chargemasters may be informative to assess the implementation of this rule and its utility to consumers. Objective We aimed to compare hospital chargemaster data within a local hospital market where patients would reasonably try to shop or compare services. Methods We identified and aggregated Dallas County hospital chargemasters available in a database compatible format in May 2019. We manually examined a convenience sampling of 10 common laboratory tests, medications, and procedures. Results Thirteen hospital chargemasters were identified. Eleven hospitals had chargemasters available in a database compatible format (xlsx or csv). These 11 chargemasters were aggregated into a single file containing 155,576 chargeable items, prices, and descriptions. We observed heterogeneous names and descriptions of synonymous items across institutions, preventing automated comparisons. The examined items revealed a high variation in charges. The largest charge variation for laboratory tests examined included a 2,606% difference (partial thromboplastin time: $18.70–506.00), for medications an 18,617% difference (5-mg tablet of amlodipine: $0.23–43.05), and for procedures a 2,889% difference (circumcision: $252.00–7,532.10). One institution accounted for 27% of the lowest prices and another accounted for 60% of the highest prices. Conclusion Chargemaster data presentation varied among the hospitals surveyed, making automatic comparison impossible. Chargemaster data are difficult to interpret for health care decisions. Refining the minimum requirements for publishing chargemaster data could increase their utility.

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