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  • Ryan Wittler

Hospitals and Insurers Really Don’t Want Us to Know How Much They Charge

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Over the past several months, the federal government has been battling hospitals and private insurance companies over a rare bipartisan goal: publishing the prices hospitals and insurers charge patients.

It’s such a hot issue that when the federal government made the rule in 2019, four hospital associations jointly sued the government to block the order. After losing that suit and the subsequent appeal, the hospitals have simply decided not to comply.

However, journalists at The New York Times and researchers at the University of Maryland have gotten tired of waiting, and they’ve done a deep dive exposing some of the worst pricing by hospitals and insurers, even finding that sometimes it’s cheaper to pretend to have no insurance at all.

Some highlights:

According to the investigation, patients getting a colonoscopy at the University of Mississippi Medical Center pay $2,144 with an Aetna plan, $1,463 with a Cigna plan, and just $782 with no insurance. At the Hospital of the University of Pennsylvania, some patients pay $93 for a pregnancy test that costs uninsured people $10.

The investigation also found that while no one large insurer is getting worse prices across the board when compared to other large insurers, they are, however, oftentime losing on pricing to smaller insurers, whom they should -- in theory -- easily beat.

What does it mean?

The experts quoted in the investigation say the work shows how these insurers who seemingly have all the negotiating power, may not actually be all that good at negotiating. It also sheds light on how slow and reluctant hospitals are to share pricing information, something that never really seems like a good thing in any transaction.

While the government can fine hospitals up to $109,500 for not providing their price information, the investigation found that the government has yet to fine any of the 170 noncompliant hospitals who have received warning letters.

According to the agency, they plan to increase the fines next year to as much as $2 million annually. “Yeah, okay. We’ll see about that,” said health insurance lobbyists (probably).

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