Healthcare News of Note: Few consumers are using publicly posted negotiated prices to comparison shop for healthcare services

• Few consumers have used posted price transparency information to comparison shop for healthcare services, and fewer still are aware of the price transparency edict, according to a recent Peterson-KFF Health System Tracker brief.
• Many parts of the country are experiencing the worst of the nursing shortage now as more nurses have retired early due to the pandemic and nursing schools are not producing enough graduates to fill the void.
• Cash payers are often charged more than health plans for the same service by the same hospital, according to a WSJ analysis of previously confidential data.

Over the last two weeks, I’ve found these industry news stories that should be of interest to healthcare finance professionals.  

1. Most consumers not comparison shopping for healthcare services

Few consumers appear to be using the price information available on hospital websites to comparison shop for healthcare services, and fewer still are aware of the price transparency rule that took effect at the start of this year, according to a recent Peterson-KFF Health System Tracker brief.

A July 2 article in Kaiser Health News reported, “In theory, releasing prices may prompt consumers to shop around, weighing cost and quality. … But, typically, consumers don’t comparison-shop, preferring to choose convenience or the provider their doctor recommends.”

The Peterson-KFF Health System Tracker brief “found that 85% of adults said they had not researched online the price of a hospital treatment” and only “14% of adults reported that they or a family member went online in the past six months to research the price of a treatment at a hospital.”

The brief also discloses that most adults do not know that hospitals are required to disclose the price of care. “Seven in ten (69%) say they are unsure whether hospitals are required to disclose the prices of treatments and procedures and an additional one in five (22%) say hospitals are not required to disclose this information,” according to the Petersen-KFF brief. “About one in ten (9%) are aware hospitals are required to disclose the prices of treatments and procedures on their websites.”

2. Nursing shortage making headlines across the country

Many parts of the country are experiencing the worst of the nursing shortage now as more nurses have retired early due to the pandemic and nursing schools struggle to produce enough graduates to fill the void.

A shortage of registered nurses had already been projected across the country between 2016 and 2030, according to the United States Registered Nurse Workforce Report Card and Shortage Forecast: A Revisit published in the May/June 2018 issue of the American Journal of Medical Quality.

An American Association of Colleges of Nursing fact sheet on the nursing shortage states, “The U.S. is projected to experience a shortage of Registered Nurses (RNs) that is expected to intensify as Baby Boomers age and the need for health care grows. Compounding the problem is the fact that nursing schools across the country are struggling to expand capacity to meet the rising demand for care.”

South Central

A July 1 article in Everything Lubbock reported, “Local hospitals are still grappling with one of the worst nursing shortages they said they’ve ever seen. As the number of COVID-19 cases go down, so too is the number of healthcare workers to take care of them.

“Nurse recruiters with Covenant Health said they’re desperately looking to fill nursing and other critical healthcare positions right now, especially as hospitals prepare for a winter experts fear might bring a new wave of the virus,” the article states.

Midwest/Great Plains

“To keep more nurses on the job and to recruit new ones, Nebraska Medicine is offering huge incentives,” according to a KETV article by Michelle Bandur.

“They have an ad for ER nurses offering a $10,000 hiring and retention bonus,” wrote Bandur.

“The hospital is also offering student loan repayment, relocation bonus of $3,000 for adjoining states and $4,500 for non-adjoining states, on top of benefits and retirement package.”

Suzanne Watson, the manager of the Nebraska Medicine ED said in the article, “Some nurses are going out of bedside nursing because of what they experienced with COVID emotionally. There are nurses that are experiencing PTSD with what they saw and the patients who had COVID.”

East Coast

Pittsburgh doesn’t seem to be fairing any better, according to an article on the WPXI-TV website.

“There’s a nationwide nursing shortage, and Pittsburgh hospitals are suffering,” wrote Jillian Hartmann.

“Chief Nursing Officer of Allegheny Health Network Claire Zangerle tells Channel 11 that the staffing crisis started before the pandemic but that COVID made things worse. For one thing, many nurses retired.

“Right now, AHN is in need of as many as 300 nurses. Zangerle said that bedside nursing is where they are understaffed, so they are offering incentives, including paying for certifications, offering a sign-on bonus for experienced nurses and incentive pay beyond standard overtime.”

3. WSJ report: Hospitals charge cash payers more than insurance companies for the same service

A July 6 article (login required) in The Wall Street Journal, reported, “Cash payers are often charged more than insurance companies for the same service by the same hospital, according to a WSJ analysis of previously confidential data.”

The analysis encompassed various emergency services using data compiled by Turquoise Health, a pricing transparency startup. “The Journal analysis looked at the 1,550 hospitals in the Turquoise data that released both insurance and cash-payment rates,” wrote authors Tom McGinty, Anna Wilde Mathews and Melanie Evans.

Among the findings:

• “Hospitals routinely bill uninsured patients at their highest rates. About 21%, or 319, of the hospitals did so for the majority of the services included in the analysis. At 171 of those hospitals, the cash rate was higher than all of the rates billed to insurers, or tied for the highest rate, for every service in the analysis.”
• “Cash prices, which haven’t been available publicly to help patients choose where to seek medical care, often vary widely even among hospitals in the same county. In the 270 counties where at least two hospitals have disclosed their cash prices, the average spread between the lowest and highest rates for a complex emergency-room visit is $1,852.”

The article also details the following:

• How various hospitals handle financial aid and other discounts for the uninsured, including how “the quarter of hospitals with the most generous free-care policies write off the entire bill for those with monthly incomes under about $2,600 a month, and even up to roughly $6,400 a month, for a one-person household.”
• What patients paid for a chest X-ray at 1,452 of the hospitals that listed a cash price and at least one price negotiated with an insurer. According to the Journal, at the majority of hospitals, charges to cash payers fell on the higher end of the spectrum of prices for that procedure.
• A review of the reasons for high cash prices, including how chargemaster prices typically are the starting point for negotiations with insurers.

HFMA bonus content

Learn about how the supply chain for PPE is getting a makeover as a result of the pandemic. See this article by Paul Barr, senior editor with HFMA.