Massachusetts General Hospital, 55 Fruit St, GRB 273A, Boston, MA.
Massachusetts General Hospital, 55 Fruit St, GRB 273A, Boston, MA.
Acad Radiol. 2020 Nov;27(11):1603-1607. doi: 10.1016/j.acra.2019.11.021. Epub 2020 Feb 1.
In 2019, Centers for Medicare and Medicaid Services enforced regulation from the Affordable Care Act, requiring all U.S. hospitals to publish standard hospital charges annually. This study assesses top U.S academic hospitals' chargemasters for selected advanced diagnostic imaging services and the usability of publicly available information to allow consumers to determine out-of-pocket costs.
Publicly available chargemasters and associated websites for the top 20 ranked hospitals in U.S. News and World Report were assessed for several features including: file format, inclusion of CPT codes, disclaimers on charges versus costs and professional fees, and tools allowing determination of actual out-of-pocket costs for selected advanced diagnostic imaging examinations.
All hospitals had publicly available chargemasters, 90% of which were in Microsoft Excel format. Ten percent of chargemasters included CPT codes. All chargemaster websites had disclaimers regarding differences between charges versus patient costs; 20% had disclaimers regarding professional fees. 20% of hospitals provided out-of-pocket costs for uninsured patients or tools allowing out-of-pocket cost determination. Median (range) MR exam charges were: brain with and without contrast: $5375 ($834-$13,857), noncontrast knee: $3402 (4530-$6924); noncontrast lumbar spine: $ 3449 ($473-$7367). Median (range) CT exam charges were: noncontrast head: $1923 ($165-$4974), noncontrast chest: $1947 ($282-$2991); contrast abdomen/pelvis: $4307 ($486-$11,726).
While all top-ranked hospitals had publicly available chargemasters, they rarely provided transparent information to allow patients to determine out-of-pocket costs for advanced diagnostic imaging services.
2019 年，医疗保险和医疗补助服务中心执行平价医疗法案的规定，要求所有美国医院每年公布标准医院收费。本研究评估了美国顶尖学术医院的选定高级诊断成像服务的主收费表，并评估了公开信息的可用性，以让消费者确定自付费用。
评估了《美国新闻与世界报道》排名前 20 的医院的公开主收费表及其相关网站，评估内容包括：文件格式、是否包含 CPT 代码、关于收费与成本和专业费用差异的免责声明，以及用于确定选定高级诊断成像检查实际自付费用的工具。
所有医院都有公开的主收费表，其中 90%为 Microsoft Excel 格式。10%的主收费表包含 CPT 代码。所有主收费网站都有关于收费与患者成本差异的免责声明；20%的网站有关于专业费用的免责声明。20%的医院为未参保患者提供自付费用或允许确定自付费用的工具。磁共振（MR）检查的平均（范围）收费如下：带对比和不带对比的脑部检查：5375 美元（834-13857 美元），非对比膝盖检查：3402 美元（4530-6924 美元）；非对比腰椎检查：3449 美元（473-7367 美元）。计算机断层扫描（CT）检查的平均（范围）收费如下：非对比头部检查：1923 美元（165-4974 美元），非对比胸部检查：1947 美元（282-2991 美元）；对比腹部/骨盆检查：4307 美元（486-11726 美元）。
虽然所有顶尖医院都有公开的主收费表，但它们很少提供透明信息，让患者确定高级诊断成像服务的自付费用。
