Hospitals are now required to post real prices!
Americans have the right to know discounted cash prices and negotiated rates.
We encourage you to check your hospitals’ website for prices, and look for the REAL price, not an average or an estimate.
Can’t find prices at your hospital? Use this link to report a hospital for not complying with the Hospital Price Transparency Rule: Submit a Complaint
The Transparency in Coverage Rule also requires health insurers to post online negotiated prices and patient cost-sharing information so patients have this critical information and knowledge of competitive choices in advance of care. Americans will soon be able to shop for the best quality of care and coverage at the lowest possible prices!
Combined, these hospital and insurance price transparency rules, along with the billing transparency order, will greatly lower healthcare costs.
American Patients will now be in charge of their health decisions and savings!
Price Transparency Will Stop Surprise Billing
Mary Washington Hospital, in Fredericksburg, Virginia, has been suing its patients for medical debt. In a town of 28,000 people, the hospital has sued over 20,000 patients in the past five years.
As a self employed handyman, Martin’s health plan costs more than doubled, and his deductible went from zero to $6,000. An unexpected diagnosis led to unexpected surprise billings that added up, forcing difficult decisions affecting his family.
Claudia needed spinal surgery. She researched the physician based on quality and coverage by her insurer. Though he advertised in network, she was surprised to learn after the surgery that he no longer accepted her plan, surprising her with a $101,000 bill.
Judy had breast cancer and was over-infused with an incorrect protocol that harmed her. After using credit cards to pay balance billing charges to doctors and hospitals, she was forced to file for personal bankruptcy. She is on Medicaid.
Planning for a new child, David and his wife were told by their doctor to get simple genetic testing. They were shocked when they received the bill.
Liz has two sons with a chronic, life-threatening health condition. Throughout their continuum of care, she has had to commit to services without knowing the price. She wants to understand who sets these high prices.
Even professionals like Dr. Lerner, a family practitioner, find themselves surprised by unknown, out-of-network fees within their own healthcare system. He recommends the same price for one patient and all patients by provider.
Price Transparency in Action
Every day, innovative employers and providers are saving thousands for patients and businesses by implementing a price transparent healthcare model.
Green Hills Direct Family Care has established a price transparent model for its patients to receive healthcare that is affordable, accessible, and attentive by removing third parties and focusing on the doctor-patient relationship.
With a previous job’s insurance plan with limited coverage, Dencina was surprised with a $17,000 bill. She is now on her new employer’s self insured plan, using only price transparent providers covering her care and sharing the savings with her — adding $5000 to her compensation.
In 1991, Rosen chose to self-insure and provide on-site healthcare. Employees pay on average $810 per year for coverage, with no co-pay or deductible. Rosen has saved over $400 million since inception of this model.
The school system estimates savings to its taxpayers of $6 million in its first year of direct contracting.
DeSoto chose to contract directly with price transparent providers and saved $1.2 million (54%) in its first year.
BevCap, a group of self-insured companies who pool their health coverage, has saved its members $98 million by directly contracting with price transparent providers.
Stauffers, a grocery and garden center in Pennsylvania, steers its employees to price transparent providers – offering employees no copay, no deductible, and cash bonuses, and saving the business on average 60% per procedure.
Texas Free Market Surgery posts its bundled prices online and guarantees its prices and quality. Patients travel from across the country to save thousands on surgery.
Employee Solutions, a Texas staffing company, uses a price transparent model and lowered its monthly healthcare cost per employee by 56% in three years.
Since posting all of their prices online eleven years ago, the Surgery Center of Oklahoma has actually lowered its prices four times. Patients travel from across the country to save significantly at the center and even use its prices to negotiate with their local hospitals.
When Lauri Moore’s fiancé as diagnosed with cancer, her insurer advised her to have a fundraiser to pay for his treatment. Now, she and her family have transparency and accountability through the direct primary care model.
We Have the Right to See Prices, Now More Than Ever
After returning from Spain, working as a teacher, Carbery Campbell fell ill with COVID-19 symptoms and went to AdventHealth for tests in Deland, FL. Although she never admitted to the hospital, Carbery received four bills totaling $6,545 for her care.
After Michelle started experiencing coronavirus symptoms she did her research on finding a COVID-19 test. She found a drive-through testing facility, who confirmed multiple times that the test was free. One month later she still had not received her test results but got a bill from her insurer for $2,045 for a test she was told would be free.
After a month of having textbook COVID-19 related symptoms, Timothy Regan went to the emergency room where he was denied a test. Instead he received several others that had nothing to do with COVID-19 and left the hospital with $3,200 in bills with no actual diagnosis. After hours on the phone, his insurance company refused to cover the bill because he did not have a COVID-19 test.
Having gone to Hartford Hospital with COVID-19 symptoms, Melissa Wilhelm Szymanski was denied a test. Instead, she received an EKG, chest x-ray, flu test, urine pregnancy test and IV fluids. Her diagnosis: potential COVID. She was charged $3,200 for five hours in the emergency room and had to spend weeks fighting these fraudulent, improperly coded bills that her insurance company refused to accept as COVID-related because she never actually received a test.
Being Hilton Head, South Carolina's first COVID-19 patient, Pamela Lazarus Rickett was charged $65,000 for eight days in the emergency room. Her treatment was not coded properly for COVID-19 even after Blue Cross Blue Shield said they would cover all coronavirus related costs for testing and treatment.
We have the Right to Complete Access to Our Health Information
According to a Winston Group survey of 1,000 Americans, 72% of Americans believe that their medical records should be automatically uploaded to a secure site so they can see all of their records in their entirety, and they can share them instantly with whomever they choose, such as a provider, family member or caregiver.
After being sent to the ER without access her medical records, Kelly was misdiagnosed with a stroke, mistreated with the wrong medications, and mischarged for it all. Not having complete access to her health information could have killed her.
Senator Mike Braun and renowned economists Art Laffer, Ph.D., Larry Van Horn, Ph.D., and Brian Blase, Ph.D. discuss how price transparency can improve patient outcomes and lower costs in a University of Kentucky Institute for the Study of Free Enterprise webinar.
Whit’s care team over looked the most significant piece of information on his medical records: he had cancer. Only through delving into his own health history did he find that his scans revealed he had renal cell carcinoma. Having access to his records saved his life.