Becker's Hospital Review

20 CFO / FINANCE 7 challenges of comparing prices for common hospital services By Katie Adams R esearch released April 9 by the Peterson-Kaiser Family Foundation Health System Tracker made it clear there's room for vast improve- ment for providers to make their pricing information more consumer- friendly to comply with the CMS price disclosure rule that took effect Jan. 1. But there are seven key challenges to comparing prices for common ser- vices across hospitals, according to the report: 1. Not all hospitals measure price the same way. Some use estimates, some use averages and some use single established rates. 2. Price information provided in machine-readable files often has missing information, failing to provide all services for all payers and rates. 3. Most hospitals don't present the price differences for inpatient and outpatient care. 4. It's often unclear if the estimated price includes the professional fee. 5. Price estimates for the same service often differ depending on wheth- er a consumer uses the hospital's price transparency tool or its machine- readable file. 6. Hospitals often make their pricing information difficult to access or search for on the web. 7. Price estimates can change over a short time. n UnitedHealth profit nears $5B in Q1 By Morgan Haefner U nitedHealth Group posted a nearly $5 billion profit for the first quarter of 2021 as its UnitedHealthcare and Optum businesses continue to grow. Five things to know: 1. UnitedHealth's revenue grew to $70.2 billion in the three months ended March 31, compared to $64.4 billion in the same period last year. 2. The UnitedHealthcare health insurance division posted revenues of $55.1 billion, up 7.9 percent year over year. UnitedHealthcare attributed the gains to expansion of its community and senior-focused health plans. 3. Optum's first-quarter revenues grew to $36.4 billion, up 10.8 percent year over year. The Optum business benefited from growth in the number of people served in value-based payment models and increasing acuity of care services provided, UnitedHealth said. 4. OptumHealth served 99 million people through the end of the first quarter. 5. UnitedHealth ended the first quarter with a $4.9 billion profit, up from $3.4 billion in the same period a year prior. n CMS bans coding hospitals use to hide prices from web searches By Jackie Drees F ederal regulators said that healthcare pricing data, which hospitals and insurers must make public under federal require- ments, should not be blocked from web search- es, e Wall Street Journal reported April 14. Six things to know: 1. In March, the Journal reported that hun- dreds of hospitals have embedded special cod- ing within their websites to block previously confidential pricing information from appearing in web searches. 2. e code prevents pages contain- ing information such as a hospital's name and prices from appearing in Google web searches, computer experts told the publication. While the prices are still there, it requires clicking through multiple layers of pages to find them. 3. Leaders of the House Energy and Com- merce Committee sent a letter April 13 to HHS calling for strict enforcement of the price trans- parency requirements. e letter cited evidence of hospitals' lack of compliance, including the Journal's analysis of more than 3,100 sites that use the search-blocking code. 4. CMS issued the guideline March 23 in an online technical forum on GitHub, a web- site and cloud-based service, that focuses on the insurer-pricing rule; the rule applying to hospitals isn't covered in the forum, the publication reported. 5. e rule change "helps clarify the intent of this regulation — make the files public and accessible," a CMS spokesperson told the Journal, adding that the agency "intends to pro- vide more guidance on this in the future." 6. CMS' statement said the hospital regulation requires the data to be "easily accessible and void of barriers" and that digital files "be digi- tally searchable," according to the report. HHS previously said it expects hospitals to comply with the price transparency guidelines and will enforce them. n

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