Fisher is optimistic about what price transparency could accomplish if hospitals follow the law, calling it “a revolution in health care to shift the power to the consumer.”
She envisions a time when anyone would be able to easily use an app or search engine to compare the cost of an MRI at every health care provider in their area under their particular insurance plan, the way one might compare airline prices when planning a trip. Currently, medical cost estimates provided by hospitals to patients ahead of time are not binding, but Fisher said there’s no reason they can’t be.
“There are a lot of technology companies coming in trying to parse this data, and they need all of the hospitals to comply to be able to create a totally competitive marketplace across the country,” Fisher said.
Some health policy experts who study consumer behavior are skeptical that such a market will ever exist. “In general, we have not found that [past] price transparency efforts have had the effect that policy makers and others have hoped,” said Dr. Ateev Mehrotra, an associate professor of health policy at Harvard Medical School who has done research on price transparency initiatives.
Mehrotra noted that many patients are either unaware of price estimate tools when they are available or decline to take advantage of them. He added that consumer behavior is also influenced by factors other than expenses, such as a referral from a doctor or which health care providers are in someone’s insurance network.
That doesn’t mean cost information is useless, though, since it could highlight which hospitals have the highest prices, Mehrotra said. “Embarrassing people is a really important tool because hospitals really, really care about their reputation,” he added.
Unions in New York City and other organizations, including PatientRightsAdvocate.org, formed the Coalition for Affordable Hospitals in October to push for lower prices and more accountability among local hospitals. The union 32BJ SEIU, a member of the coalition, recently removed New York-Presbyterian from its health plan network because of hefty bills and has held rallies calling the health system out.
“Hospital overpricing is not unique to Presby,” said Kyle Bragg, president of 32BJ, in an interview on the price transparency report. “We have to get these hospital systems in line. There’s no reason why this information should be kept secret.”
In a statement, New York-Presbyterian said, “We care for everyone who walks through our doors, regardless of ability to pay. We are one of the largest providers of Medicaid in the state and we have an extensive financial aid policy.”