HCA expands price transparency

More potential HCA Inc. patients will be able to check prices in advance of treatment as the network expands its price transparency initiative to include all of its 183 hospitals by mid-summer. The initiative began in the for-profit chain's Dallas market in October 2006.

Each of HCA's hospitals will have a link on its Web site detailing the program and how to obtain information in both English and Spanish. Uninsured patients can obtain a list of prices for the top 22 procedures. Insured patients can call HCA to get insurer-specific information detailing an estimate of out-of-pocket expenses.

HCA spokesman Ed Fishbough said if an insured patient has all the necessary information, which is detailed on the Web site, the call can take less than 10 minutes.

From October 2006 through February 2007, more than 2,300 unique visitors went to HCA's pricing Web site, and 209 calls have been made to obtain information. Fishbough said the calls were about evenly split between those from uninsured and insured patients. The largest number of requests concerned maternity services, he said.

HCA's efforts came in response to President Bush's launching of a national price transparency initiative last spring. Also as part of that initiative, the Centers for Medicare & Medicaid Services in November 2006 posted online pricing information for selected services performed in physician offices and outpatient departments of hospitals. Medicare posted similar data for inpatient hospitals last June and ambulatory surgical centers last August.

Amy Lee, spokeswoman for the American Hospital Assn., said about 40 states now have some kind of pricing transparency policy in place. These join several other individual hospital efforts, some of which have included partnerships with insurers, Lee said. The AHA in April 2006 published guidelines for establishing price transparency programs.

However, there is still debate on how much price transparency helps consumers. A recent study funded by the California Health Care Foundation found posting fee schedules may do little to help consumers make better health care choices.

"Much of the recent policy discussion about price transparency downplays the complexity of decisions about medical care, patients' dependence on physicians for guidance about appropriate services and the need for information on quality," the report said.

The American Medical Association supports the posting of prices by physicians and others. But the Association says true transparency will come only when insurers reveal to consumers what they pay.