Jeff Leibach, Las Vegas Review-Journal
If you need an “ICD PRTCTA DR US MR BCP” procedure at Sunrise Hospital and Medical Center, the charge will be $100,000. If, instead, you’re destined for a “Card perf spect mlt with and without wm/ef” at Valley Hospital Medical Center, it will run $15,917.
But you’re on your own when it comes to figuring out what those procedures or drugs or medical devices are.
Those and many other indecipherable descriptions and cost estimates are now posted on the websites of 13 hospitals in the Las Vegas Valley to comply with a new federal rule designed to provide additional consumer transparency into the actual cost of hospital care. The state’s Rawson-Neal Psychiatric Hospital in Las Vegas plans to post prices this week after encountering a technical difficulty, a spokeswoman said.
The lists of charges are required to be posted on hospital websites in a “machine-readable” format under the vague new rule implemented on Jan. 1 by the federal Centers for Medicare and Medicaid Services amid a growing debate over rising health care costs. But there was no requirement that the procedures be understandable by anyone other than a hospital billing specialist.
“I think it’s pretty meaningless to patients in most cases,” Erin Fuse Brown, a health law and policy professor at Georgia State University, said of the new information. “If the procedure isn’t understandable, it’s not going to provide much price transparency to patients.”
Hospitals in the Las Vegas Valley complied with the mandate in various ways. Sunrise Hospital posted nearly 40,000 lines of data, while others posted approximately 5,000. Veterans Administration hospitals are exempt because of the way they are reimbursed for services, according to CMS.
Varied costs for whatever it is
Most of the descriptions appear to be lifted from medical shorthand that accompanies the hospitals’ billing codes. But because codes aren’t uniform across hospital groups, one institution’s name for a heart transplant procedure may be called something else at another hospital.
With one exception — Dignity Health-St. Rose Dominican — hospital representatives declined to explain what examples culled from their lists actually were.
The data do show that prices can vary sharply even within a single hospital group.
Valley Hospital and Desert Springs Hospital Medical Center, both part of the Valley Health System, provide the same service: “ECMO OR TRACH W MV >96 HRS OR PDX EXC FACE, MOUTH & NECK.” But the cost of it runs nearly $2.8 million at Valley Hospital and just shy of $1.5 million at Desert Springs. In fact, the service at Valley is the most expensive charge listed by Vegas-area hospitals.
The Valley Health System did not respond by deadline to a request to explain the disparate charges.
Jeff Leibach, a health care analyst with Navigant, said hospitals were also uncertain what they needed to do to comply with the rule.
“The federal rule is pretty open-ended in what it required hospitals to provide,” he said.
The medical industry has been scolded for shrouding patient costs in secrecy. In that respect, critics say, it’s unlike any other industry.
When you go to an auto repair shop, workers give you quotes for parts and service. You can try to negotiate, but you will know before the service is delivered how much it will cost.