Ward Christine, Reeder Tim
general surgery resident, Stony Brook University Hospital, Stony Brook, New York.
associate professor and vice chair of clinical operations, Department of Emergency, Brody School of Medicine, East Carolina University.
N C Med J. 2020 Mar-Apr;81(2):95-99. doi: 10.18043/ncm.81.2.95.
Health care costs are on the rise and causing financial burden for many patients. Price transparency has been proposed as a tool to control health care costs. New federal legislation requires all hospitals to publish their chargemasters, or price lists, on their websites as of January 1, 2019. All general acute care hospitals in North Carolina were contacted in 2017 to request price information. After mandatory chargemaster publication was in effect in 2019, all hospitals previously contacted had their websites evaluated for chargemaster availability. Price information collected in 2019 was compared to information collected in 2017. Zero percent of hospitals provided access to chargemasters in 2017, and 72% provided access in 2019. Average price per queried item decreased from 2017 to 2019. Price variability also decreased. However, there was no statistical significance when comparing price means. In 2017, price data was limited due to low hospital participation when queried for prices. In 2019, this study's definition of "access to chargemaster" inadvertently excluded some North Carolina hospitals from qualifying as providing price access. After mandated chargemaster publication, consumer access to hospital price lists greatly increased in North Carolina. Price data, although limited, reveals decreased mean prices and decreased price variability for queried procedures after chargemaster publication was required.
医疗保健成本不断上升,给许多患者带来了经济负担。价格透明度已被提议作为控制医疗保健成本的一种手段。新的联邦立法要求所有医院自2019年1月1日起在其网站上公布收费明细,即价格清单。2017年,研究人员联系了北卡罗来纳州的所有综合急性病医院,以获取价格信息。在2019年强制公布收费明细生效后,对之前联系过的所有医院的网站进行了评估,以查看是否有收费明细。将2019年收集的价格信息与2017年收集的信息进行了比较。2017年,0%的医院提供收费明细,2019年这一比例为72%。每个查询项目的平均价格从2017年到2019年有所下降。价格差异也有所减少。然而,比较价格均值时没有统计学意义。2017年,由于查询价格时医院参与度较低,价格数据有限。2叭9年,本研究中“获取收费明细”的定义无意中将一些北卡罗来纳州的医院排除在提供价格查询的合格范围之外。在强制公布收费明细之后,北卡罗来纳州的消费者获取医院价格清单的机会大大增加。价格数据虽然有限,但显示在要求公布收费明细之后,查询程序的平均价格下降,价格差异减少。