Becker's Hospital Review

11 CFO / FINANCE 'As transparent to me as hieroglyphics': Why patients can't decipher hospital prices posted online By Katie Adams C MS' price transparency rule was enacted to help patients compare hospital pric- es for the same services, but it's nearly impossible for the average person to under- stand the pricing information hospitals have posted online, according to a July 9 Kaiser Health News report. e report's author, Bernard Wolfson, details his journey of trying to compare the prices for common services between Oakland, Ca- lif.-based Kaiser Permanente and Sacramento, Calif.-based Sutter Health. Mr. Wolfson said he quickly found that task to be fruitless, as "the tangled web that long has cloaked hospital pric- ing" was too confusing to decipher. "You are a healthcare reporter, I'm a healthcare lobbyist, and the fact that we can't do this our- selves is an indictment of where things stand at this point," Shawn Gremminger, health policy director at the Purchaser Business Group on Health, told Mr. Wolfson. "e subset of peo- ple who can do this is pretty small, and most of them work for hospitals." When sharing an example of the frustrations he experienced trying to compare hospital pric- es, Mr. Wolfson said Sutter's Alta Bates Sum- mit Medical Center in Oakland listed the same outpatient procedure with the same CPT code three times, all with different prices: $1,912, $3,650.85 and $5,475.80. He said confusing listings like this make it "almost impossible for mere mortals to anticipate the total cost of their medical procedures, let alone compare prices among hospitals." "e prices I examined were as transparent to me as hieroglyphics, and I'm pretty sure that hospital executives — who unsuccessfully sued to stop implementation of the price transpar- ency rule — are not losing any sleep over that fact," Mr. Wolfson said. n 10 hospitals ranked highest for investments in community health, per Lown Institute By Alia Paavola F ive New York hospitals ranked among the top 10 hospitals for com- munity health investment in the U.S., according to a ranking published July 12 by the Lown Institute, a nonpartisan healthcare think tank. The Lown Institute's Hospitals Index 2021 Community Benefit rank- ing is the first ranking to examine hospitals' charity care spending and community investments. For the report, the Lown Institute examined 3,641 hospitals based on Med- icaid revenue, charity care spending and other community health invest- ments. Data came from hospital cost reports filed with CMS and IRS 990 forms from 2018. Ten hospitals that performed the best: 1. Paradise Valley Hospital (National City, Calif.) 2. Elmhurst (N.Y.) Hospital Center 3. Queens Hospital Center (New York City) 4. Metropolitan Hospital Center (New York City) 5. Woodhull Medical and Mental Health Center (New York City) 6. Leonard D. Chabert Medical Center (Houma, La.) 7. NYC Health + Hospitals Coney Island (New York City) 8. Lallie Kemp Medical Center (Independence, La.) 9. Zuckerberg San Francisco General Hospital 10. The University Hospital (Newark, N.J.) n Hospitals blast UnitedHealth profits By Morgan Haefner U nitedHealth Group's second-quarter earnings stem from "not pay- ing for healthcare," American Hospital Association President and CEO Rick Pollack wrote in a July 15 blog post. In the second quarter of 2021, UnitedHealth posted $4.3 billion in profit, down nearly 36 percent from $6.6 billion a year prior. Mr. Pollack argued these profits were earned from deferred care during the pandemic, as well as updated policies from the health insurer, including coverage restric- tions around specialty pharmacy, hospital outpatient surgeries, and hospi- tal-based lab and radiology services. "United routinely rolls out these coverage restrictions throughout the year, meaning that enrollees purchase their health plans under one set of rules only to later learn that their providers and cost-sharing responsibilities have changed," Mr. Pollack said. UnitedHealth didn't respond to Becker's request for comment by the time of publication. n

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