KANSAS CITY, Mo. — Twenty-year-old college student Mason Kochel was shocked when he saw the bill for an emergency room visit. Among the charges was $15,000 for an epi pen to help with an allergic reaction after having unknowingly eaten a cashew.
“I couldn’t believe it,” Kochel said of the Colorado hospital bill. “It was insane.”
Kochel said he could have bought two epi pens for just $200 at a local pharmacy.
Many hospitals have earned a reputation for outrageous charges for everything from a box of tissues to putting your arm in a sling.
That’s why, starting in January, hospitals were required by the feds to list their prices online for at least 300 services so patients could compare prices among hospitals even among the negotiated rates by insurance plans at those hospitals.
So how’s it going? Not good, according to a survey of 500 hospitals by a consumer advocacy group called Patient Rights Advocate.
According to the survey, only 5.6% of the hospitals surveyed were compliant with federal regulations on price transparency. Among those not in compliance were every hospital surveyed in Kansas and Missouri, including Shawnee Mission Medical Center, St. Luke’s and the University of Kansas Hospital.
The Patient Rights Advocate survey released in July of this year noted that Barnes Jewish Hospital in St. Louis was deemed out of compliance in every category during a check on June 11.
After this story was first published, Hospital Spokeswoman Laura High contacted FOX4 and said in an e-mail that the hospital, and all the BJC Healthcare hospitals in Missouri and Illinois “are in compliance, including Barnes-Jewish Hospital, and have been in compliance since early this year.”
High said patients can use the BJC.org website and said the pricing information can be found under the financial assistance and billing resources section under “Understanding Your Costs.”
The Patient Rights Advocate group noted in their survey that Barnes-Jewish Hospital was non-compliant because on the hospital website information didn’t provide the required pricing information in the format necessary. “Standard charges file is a tool, not a machine-readable file, with no data. Price estimator is in a non-compliant form,” the group said in their evaluation.
When asked for a response to the specific findings in the Patient Rights Advocate report, High said she had “nothing additional to add.”
When hospitals aren’t transparent in their pricing, patients become victims, said Cynthia Fisher of Patient Rights Advocate. Fisher said prices can vary dramatically for the same procedure even if they are performed at the same hospital.
“One woman’s negotiated rate for her C-section was a little over $6,000,” Fisher said. “Another woman was charged $60,000. That’s 10 times more in the same hospital.”
Although hospitals are now required to post their prices online, finding them can be a challenge, FOX4 Problem Solvers discovered. You have to know where to look. Problem Solvers found the price estimator usually located under patient billing on each website. Then we tried to compare prices. We looked for the price of a colonoscopy on St. Luke’s website. Even though we filled out all the required boxes, the estimator wouldn’t give us a price. Instead, we got a message telling us to call.
The price estimator for KU Hospital was better. It did provide us with the cash price of the procedure, assuming we didn’t have insurance, but not the insured price.
Plus most hospitals, FOX4 Problem Solvers found, included a disclaimer saying they were only estimates and the actual price could vary, making the estimate almost worthless and not in compliance with federal regulations, Fisher said.
Frustrated that so many hospitals are out of compliance, the Biden administration is cracking down. It’s upped the penalty for larger hospitals to a maximum of just over $2 million per year. The smallest of hospitals could face a maximum of $109,500 in fines per year.
Once hospitals become compliant, the public should eventually be able to use a tool similar to Kayak or Expedia to compare prices for everything from colonoscopies to hysterectomies.
By the way, the bill for Mason’s $15,000 epi pen was eventually dismissed by the hospital as a billing error after he disputed the charge with help from Patient Rights Advocate.