Hospitals required to list “chargemaster” price for all medical procedures

Posted at 4:24 PM, Jan 04, 2019
and last updated 2019-01-04 16:39:41-05

GRAND RAPIDS, Mich. - Medical patients have a new tool for price checking their procedures, thanks to a new federal mandate in effect in 2019.

The mandate requires hospitals to publish their starting price tags, or "chargemasters," online for every service or procedure.

"Not every hospital across America was doing this, that’s why the Trump administration felt it necessary to implement this rule," says Matthew Cox, the Chief Financial Officer at Spectrum Health.

The list is indeed new to many, but not Spectrum Health.

In an effort to be transparent with customers, they've been publishing average prices for procedures such as child birth, MRIs, and X-Rays since 2006.

Now they're posting chargemaster pricing as well.

Cox tells us the demand for pricing tools has gone up; "So the demand has really changed over the past few years where patients used to occasionally call for estimates because deductibles were smaller in the past, but now as deductibles have risen and co-insurance has risen, we’re getting a lot more demand for our financial counselors, and for people asking for estimates."

So what exactly does this price tag or "chargemaster" represent?

Cox tells us, "The charge is the sum of all the different components that build up to the price, it's all the different things that go into it. Like a knee replacement, could be the implant, could be the surgery, the length of stay that we expect in the hospital."

However it's important consumers don't get sticker shock from that large sum, because health care professionals emphasize that these price tags are hardly realistic, they're simply starting points for payment negotiations between hospitals and insurance companies.

"So if you have insurance and you look at the price you may wonder, 'What is my insurance gonna pay?' 'What is my deductible gonna be?' And what we do is we have financial counselors that can meet with patients and talk through all of the details," says Cox.

Every person's cost is different.

So yes, this chargemaster price is a new handy tool as a starting point, but by all means keep researching.

"I would tell people that they should call our financial counselors and get an exact estimate of what the prices are gonna be for major surgeries. That is gonna let them know how much it is gonna cost them given their insurance that they have, and the different deductibles that they may have, co-insurance they have, and it's gonna let them be able to plan much better than just looking online and seeing an average price," says Cox.

For a list of Spectrum Health's pricing, click here.