By Ted Shaw, President/CEO, Texas Hospital Association
As the health care landscape has continued to evolve, health care consumers have been asked to bear a larger share of the costs of their health care–whether because of high-deductible health plans or increased cost-sharing requirements. As a result, patients’ interest in the amount they pay for health care services has increased, and Texas hospitals have been at the forefront of providing meaningful price transparency.
Although health care consumers consider a number of factors, in addition to price, when making health care decisions, President Donald Trump in late June issued an Executive Order directing the U.S. Department of Health and Human Services to issue a rule requiring hospitals to disclose the amount health insurers and patients pay for health care services.
Sound decision making requires an honest look at all of the variables affecting the choice. Hospitals, like physicians, nurses, employers, health insurers, and patients themselves, are equal partners in promoting a positive patient experience and ensuring the best health outcomes. And, each stakeholder equally shares responsibility for good health care decision making.
When consumers make decisions about their hospital care, price is one factor to consider alongside a host of others. Physician referral, friend and family experience, reputation, specialty, or center of excellence status and, namely, health plan network status all are important factors that influence a health care decision. Focusing only on price as a decision-making guide is unwise and rarely should occur with regard to one’s own health outcome.
Every day, Texas hospitals empower health care consumers to make informed decisions about their medical care. Through online tools like PricePoint and conversations with patients ahead of elective and scheduled procedures, Texas hospitals provide price and cost-sharing estimates before care is delivered.
Hospitals are unlike global retail chains, such as Walmart and Costco. In order to save lives and help heal people, Texas hospitals must provide specialized care that is specifically tailored to the ebbs and flows of an individual’s unique needs and circumstances. As such, hospital prices can fluctuate with the care they provide, and there are valid, economic reasons for those price differences.
Hospitals’ prices reflect the disparate communities they serve and their unique demographics and needs. This is particularly true in a state as large as Texas. A designated trauma hospital in the Houston metroplex may have the capacity to provide different services and a higher level of care from a critical access hospital in Pecos County. Pricing structures reflect community needs and characteristics as well as hospitals’ own investments in physician and nurse workforce, technology and often, research capabilities.
In addition, it is important to remember that hospital-health plan negotiations are private. Requiring public disclosure of these arrangements could have the very adverse consequence of driving up health care costs for the patients the rule seeks to protect.
As with many issues in health care, price transparency is complex and requires engagement of all stakeholders along the continuum of care. Providing the highest quality care and supporting a positive patient experience are hallmarks of Texas hospitals’ work and they look forward to working with HHS as well as physicians, employers, and health insurers to ensure meaningful transparency for Texas patients.