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Health Care

Still Waiting on Price Transparency

By Elias Tsapelas on Jun 30, 2023
Hospital bill
9dream studio / Shutterstock

Why is it so hard to figure out how much health care services are going to cost? It has been two years since the federal rule requiring that hospitals disclose their prices in a consumer-friendly format went into effect. Last year, it was reported that fewer than one in four hospitals were complying. Today, are consumers any better off?

Last month at a congressional hearing, Rep. Jason Smith stated that hospital compliance was still incredibly low, and only four out of 6,000 hospitals nationally have been fined. The American Hospital Association (AHA) claims compliance is much higher—around 70%—and the lack of fines is because many hospitals are working with the Centers for Medicare and Medicaid Services to become compliant as prescribed in the rule.

A little less than a year ago, my colleague checked nearly every hospital in the state for compliance, which was not an easy task. Compliance was at less than 30% statewide, and calling many of those websites “consumer-friendly” was a bit of a stretch. Now, taking the AHA’s claims about improvement with a grain of salt, I wanted to check some of Missouri’s hospital websites for myself.

The good news is that the interface on many of the websites appears to be better. I could more easily search for a few basic health care services, but I would still say the process was more difficult than it should be. Additionally, one of the most important benefits of price transparency is the ability to “shop” around; doing that is quite difficult because it requires navigating to each hospital’s website separately and trying to find the same procedure price bundles to compare.

If this is what compliance looks like, Missouri’s got a long way to go. Fortunately, some states across the country have already made a concerted effort to be compliant, as well as increasing costs for hospitals that remain noncompliant with federal transparency rules. States such as Florida and Maine have created their own online tools that make comparing prices and services between hospitals much easier. Some states, such as Colorado, take the push for price transparency a step further and prohibit health providers that refuse to disclose their prices from using the state court system to collect medical debt.

This past legislative session, there was some hope that Missouri would join the ranks of Colorado with a similar bill restricting providers that aren’t transparent from collecting medical debt, but the bill that was filed never received a hearing. As far as I know, there hasn’t been any movement on creating a state-sponsored price comparison tool.

Price transparency is not some cure-all that will fix everything that’s wrong with America’s health care system. But making it easier for patients to see what they’ll have to pay before they’re told to pay it would represent a significant step forward, and other states are making progress on this front while Missouri lags behind. Although there has been some progress since last year, there’s still plenty of room for improvement on the health care price transparency front in our state.

Topics on this page
MissouriFloridaColoradoMaineCenters for Medicare & Medicaid Services
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About the author

Elias Tsapelas

Director of State Budget and Fiscal Policy

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