Effective Jan. 1, the Centers for Medicare and Medicaid Services (CMS) requires all hospitals nationwide to establish, update and make available on the internet a list of their Standard Hospital Charges/Diagnosis Related Group Charges. This list captures most items and services provided to patients. The new regulations require the list to be available in a machine-readable format that can be accessed by patients and automatically read and processed by a computer.
As every insurer pays hospitals differently, the list of charges does not represent the true costs of care for patients – in fact, the costs are usually significantly less – and it is not a useful tool for patients who are evaluating costs of care. While the intent of CMS is to increase price transparency, this new regulation may create confusion for patients. Clinicians and front-line staff may receive questions from patients about the charge lists and their accuracy.
Partners is working with all hospitals, including the MGH, to ensure they comply with this regulation and to ensure that patients have the appropriate channels to get accurate information about their health care costs. Most Partners hospitals will link to the Patient Billing and Financial Assistance section on http://www.partners.org. If a patient goes to the Partners site, they will be re-directed to the best way to request a cost estimate, which is to contact Patient Billing Solutions at 617-726-3884.
For help responding to patients with questions, please review the “Hospital Price Transparency QA” document on Partners Pulse.
This article was originally published in the 01/11/19 Hotline issue.