About half of Colorado hospitals posted close to all of their prices required under federal transparency rules, a new report found.
Turquoise Health, a software company focused on price transparency in health care, rated 107 hospitals in Colorado and more than 6,000 nationwide based on how complete their machine-readable files of prices were.
Federal rules require hospitals to post their full list of prices in a format that a computer can search, as well as a list of 300 “shoppable” services or a cost-estimating tool. Turquoise Health used an algorithm measuring how complete the files were on 60 different measures.
Fifty of the 107 Colorado hospitals received five stars. That doesn’t mean their files were perfect, but they included sticker prices, discounted cash prices and prices they negotiated with insurance companies for “a significant quantity of items and services,” according to the report.
A five-star ranking doesn’t necessarily mean that a hospital is complying with all federal rules, but it’s a sign that patients have access to better information for making decisions about care, said Carol Skenes, a payer and provider specialist at Turquoise Health.
Colorado hospitals scored better than many states, which may reflect the amount of attention on transparency in the last few legislative sessions, she said.
“There are a handful of states that have taken price transparency as a central tenet,” she said. “I think there is a lot more motivation for people to get their ducks in a row.”
In 2022, Colorado passed a law forbidding hospitals from pursuing aggressive debt-collection techniques, like sending patients to collections, if they haven’t posted all of their prices. Patients have to realize the hospital hasn’t complied, however, and file a lawsuit on their own. A bill this session would allow the state to enforce federal transparency rules, and require hospitals to present the information in a standard format.
The Colorado Hospital Association released a statement saying it believes hospitals in the state are complying with federal rules. Facilities also have taken extra steps like creating price estimation tools and hiring staff to field calls from patients wondering what they might pay, it said.
“Our hospitals have a long history of supporting meaningful price transparency that helps patients understand their financial responsibility in advance of receiving care,” the statement said. “We don’t agree that scrutiny of transparency has led to increased compliance — instead it has been a matter of understanding the complicated requirements of this rule and investing the resources needed to comply, during one of the busiest times our hospitals have seen in recent years.”
The Turquoise Health report estimated about 84% of hospitals nationwide had posted at least some price data. More than half of all ranked hospitals got five stars, though the smallest (25 or fewer beds) and largest (more than 250 beds) were the least likely to meet that threshold.
Twelve Colorado hospitals weren’t ranked because they didn’t post enough information. Six are rural facilities, which tend to have fewer resources to put into compliance, and five are psychiatric hospitals, which perform such different services that much of the required information for general hospitals isn’t relevant, Skenes said.
Of the 107 Colorado hospitals:
• 15 didn’t include their negotiated rates
• 22 didn’t include their cash prices
• 22 didn’t include inpatient rates
• 18 didn’t include outpatient rates
• 24 didn’t include rates for outpatient surgery
• 25 didn’t include any rates for drugs
• 60 didn’t include negotiated rates for drugs
• 86 didn’t include negotiated per diem rates
If Colorado passes a bill that requires a standardized format for hospitals’ price files, it could make the information easier for individuals and groups like Turquoise to use, Skenes said. It’s not realistic to expect regular people to pull multiple hospitals’ files and try to compare them, so shopping will become easier as comparison tools improve, she said.
“I think that structure will help people get their data organized,” she said.
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