Hospital chargemasters are plagued with data problems, including cryptic codes, hard-to-understand drug names, and duplicate data.
It's been a rough week for the Centers for Medicare & Medicaid (CMS) rules that took effect Jan. 1 requiring hospitals to provide detailed pricing information on their websites to allow for easy cost comparisons.
First, a new Health Tracking Poll from the Kaiser Family Foundation, a health policy analysis organization, revealed that "the vast majority of adults are unaware [of] or say this requirement does not exist."
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And now, a new GoodRx report contends that "most hospital chargemaster lists are anything but transparent."
"These chargemaster prices are riddled with data issues, are unapproachable for patients, and only really highlight the variable and seemingly random nature of hospital pricing," writes Tori Marsh, a member of the GoodRx research team, which compared chargemaster prices to pharmacy cash prices for commonly filled medications. "These cash prices, also referred to as the average retail prices, are readily available, and provide a good benchmark for a 'fair' price a consumer should pay. But according to our research, in a hospital setting, things aren't always fair."
4 key takeaways
GoodRx's report details what the company's research team found when exploring chargemaster prices at 16 hospitals for 12 common drugs. Here are four key findings:
1. Charges for routine generic drugs are expensive and vary from hospital to hospital — by more than $50 per tablet or capsule, in some cases.
2. Chargemaster prices for generic drugs can be almost 6,000% higher than the average retail price at pharmacies nationwide.
3. Of the 16 hospitals GoodRx investigated, only six adhered to the CMS regulations regarding price transparency.
4. Hospital chargemasters are plagued with data problems, including cryptic codes, hard-to-understand drug names, and duplicate data.
"It's clear that new legislation aimed at improving transparency may only be a Band-Aid on a gaping issue within healthcare pricing, and patients, especially the most financially vulnerable, may still be left in the dark," Marsh concludes.
The report also includes suggestions for improvement — including use of standardized data files, providing more specific drug information, implementing data checks to remove duplicate prices, and offering more robust insurance information.
GoodRX also recently analyzed the substantial cost variation for common labs and tests in hospitals.
