New hospital price transparency initiatives in WA, PA

Hospital price transparency is slowly edging its way into the mainstream, with two new initiatives announced in Washington State and in Pennsylvania.

The Washington initiative is far more ambitious, involving every hospital in the state posting prices held in a public database. In Pennsylvania, a small hospital system plans to disclose its prices for 25 common outpatient procedues.

Washington Gov. Jay Inslee wants a public database that would list the prices of hundreds of procedures for every hospital in the state, according to Kaiser Health News. The initiative was developed in the wake of advocacy groups criticizing Washington for its price opacity.

"We made a decision with the Affordable Care Act to use competition to control costs," Bob Crittenden, Inslee's senior health-policy adviser, told Kaiser Health News. "Competition requires a number of things. You need enough information to make decisions, and we don't have that right now."

The proposal has a lot of support from the provider community, although the state's two biggest health insurers--Regence Blue Shield and Premera Blue Cross--have objected to revealing prices they negotiated with providers in confidentiality.

Pennsylvania proposes a smaller initiative. Heritage Valley Health System, which operates two small hospitals in the towns of Sewickley and Beaver, will post the prices for 25 outpatient procedures, exclusive of physician charges.

"With the changes of the Affordable Care Act, with many uninsured patients in Pennsylvania, having a pricing transparency for the hospitals for the outpatient costs is going to be very important moving forward," Dan Murphy, a Heritage official, told CBS Pittsburgh. Pennsylvania is currently not expanding its Medicaid program, excluding about 400,000 residents for now from obtaining coverage that would pay for their care.

Although two of the state's biggest hospital systems, UPMC and the Allegheny Health Network, do not post prices, a statement from the latter said it was assessing strategies for delivering price transparency to its patients, according to CBS Pittsburgh.

Price transparency at hospitals has received heightened scrutiny, particularly as journalist Steven Brill chronicled in Time magazine last year how many hospitals ignore their own chargemasters and often charge the maximum to uninsured patients.

To learn more:
- read the Kaiser Health News article
- here's the CBS Pittsburgh article

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