Hospitals on Long Island and around the country have been required since Jan. 1 to post online what they charge for their services, ranging from bladder examinations to ventricular shunt procedures.
The new federal requirement is a good but incomplete first step toward helping patients understand the high cost of services, health care and hospital experts said. The required listed prices, they said, aren’t all that insightful because patients rarely pay those full prices.
Health systems also offer patients information assistance that’s more realistic than the required list prices, experts said.
“Health care price transparency can potentially be useful. because it will shine a light on the high price of health care,” said Larry Levitt, a senior vice president at the Kaiser Family Foundation, a nonprofit that focuses on health care policy. But the new requirement alone is “not going to be helpful for consumers to use as a guide to shop around, because there is a difference between the list prices and the prices insurers negotiate with health systems. The negotiated price matters. The listed price doesn’t tell consumers very much.”
Most patients also often don’t know detailed aspects of their procedure, which makes it difficult to know what a final cost would be, said Brian Fullerton, director of revenue cycle at Stony Brook Medicine. Various health systems also use different formats — which can be hard for patients to interpret — in their lists.
But Fullerton said patients are growing more interested in the cost of care, because “new benefit designs have shifted costs to the consumer.”
“More people have high-deductible plans,” he said. “A $5,000-deductible plan is not small. It can be painful, and people notice.”
Still, even the uninsured won’t pay the list prices, experts said.
The list price is “even less relevant in New York State, where hospitals offer a reduction for those without insurance,” said Elisabeth Wynn, executive vice president, health economics and finance, for the Greater New York Hospital Association, which represents hospitals in the New York metro area, including Long Island.
New Hyde Park-based Northwell Health, the largest private employer in the state, with 68,000 workers, has an expense calculator on its site that estimates costs based on a patient’s insurance.
“It’s more useful than simply posting list prices,” said Richard Miller, executive vice president and chief business strategy officer at Northwell. “But it’s really only an estimate because of the uniqueness of insurance coverage. We recommend people call one of our counselors. They’ll get a human being to talk to, and it will be more fruitful than any online tool.”
Other health insurers offer similar services. NYU Langone, like many hospitals, has financial counselors who help patients understand bills. The Manhattan-based group also offers financial assistance programs. Higher deductibles and copays have led to more financial assistance requests, a NYU-Langone spokeswoman said.
Stony Brook University Hospital has counselors and also offers a financial-assistance program, Fullerton said.
Catholic Health Services also has financial counselors who help a patient navigate the cost of health care. CHS added everyone receives care at their facilities.
“Regardless of their ability to pay, CHS will not deny patients access to medically necessary hospital services,” said Meredith Simonetti, Catholic Health Services’ vice president for revenue cycle services.
As for the list price of an inpatient ventricular shunt procedure at Long Island Jewish Hospital? It’s $17,656. The actual cost of the procedure can vary greatly depending on a patient's insurance.