What would be in a hospital bill we could all understand?

The U.S. Department of Health and Human Services has launched a contest to see who can design a hospital bill that patients can actually read..

It's been an open secret that most hospital bills have been unreadable for decades. The through line is pretty clear--my friend and colleague Lisa Zamosky was sent home with single item $235.65 bill when she was born at the end of the 1960s. Much more recently, journalist/entrepreneur Steven Brill presented a bill for part of a medical procedure to Stephen Hemsley, CEO of UnitedHealth, for his translation services. Hemsley, whom I presume is no dummy, was unable to say what the bill actually represented.

"This challenge is part of HHS' larger effort to put patients at the center of their own healthcare," said HHS Secretary Sylvia Mathews Burwell in a statement. "With today's announcement, we are creating progress toward a medical bill that people can actually understand and a billing process that makes sense--progress that includes creating a forum that brings everyone to the table: patients, doctors, hospitals, insurance companies and innovators."

Of course, a clear bill could open up a big can of worms. Many hospital operators would probably be uneasy that the services they charge for would become much clearer and apparent to their patients. But given the recent trends toward cost-shifting to consumers, it may be a good idea to have them in better graces in order to more effectively collect what's owed.

I'm curious to see what a "winning" bill would look like. But perhaps I can make some suggestions as to what a truly transparent bill for a patient would look like:

ABC Hospital


Bill for services

Patient experience scorecard

  • Your doctor forgot your name: 7 times
  • A nurse muttered about you behind your back: 33 times
  • ‚ÄčThe orderlies were relieved you did not require a bedpan: 112 times
  • Your TV remote stopped working: 16 times
  • You were unable to find a comfortable position in bed: 292 times
  • You were served an unidentifiable protein substance during a meal: 21 times


Procedure and diagnosis code manuals.... $392.50 
This is actually not for you, but for us. We have to keep up with lots of codes.

Procedure code 12345 Bile Removal.... $3,700.26 (Unsuccessful procedure)
This is to remove the bile floating free-form within your body. For some reason we could not retrieve it all. You should get that checked at the first possible opportunity.

Procedure code 23456 Wi-Fi.... $92.16
We would like to provide free Wi-Fi to all patients and their family members. We don't, but we believe the kind thought on our part is worth something.

Procedure code 34567A  Name change... $313.83
We know staff kept on referring to you as "Mr. Shrinkman" throughout your stay. We have endeavored to correct that--for a small convenience fee, of course. Please let us know how we're doing!

Procedure code 45678B  Club surcharge... 98.16 
We actually don't have a club on the premises of ABC Hospital, but we recently began paying for club memberships for our executive staff. Someone has to pay for that. You understand.

Procedure code 56789A Band-aids... $9,116.78.

Total.... $13,713.69

You will receive a separate bill regarding the incidentals of your hospital stay shortly.

If you have any questions or objections, please do not hesitate to call our billing and hospitality department between the hours of noon and 1 p.m. weekdays. Please note that normal lunch hours for departmental staff are observed.

Thank you for making your stay at ABC Hospital. We're proud to provide you transparency you can see through! -- Ron (@FierceHealth)