Advocacy Group Claims Hospital Pricing is Unclear for Patients in Kansas City, Despite Federal Transparency Laws

Advocacy group says pricing at Kansas City hospitals isn’t clear for patients

A leading advocacy group has claimed that hospital pricing isn’t clear for patients in Kansas City, Missouri. Despite a federal law requiring hospitals to reveal their price listings for various services, a report from the Patient Rights Advocate (PRA), a consumer group based in Washington, D.C., suggests that only 22% of hospitals in Missouri are fully complying with this regulation.

Understanding Costs of Medical Services

According to Cynthia Fisher, the founder and chairman of PRA, knowledge of actual prices can help patients prove if they have been overcharged for healthcare services. However, she said finding this information can often be tricky.

The current regulations necessitate hospitals to publicly post data concerning every service they offer and every drug they provide. This data includes true costs negotiated with an insurer and the amounts a cash-paying patient would be charged.

Lack of Compliance with Regulations

Based on PRA’s report, only 10 out of 46 hospitals reviewed in Missouri were fully compliant with these regulations. This suggests an alarming number of hospitals failing to comply with the federal law, leading to uncertainty and confusion for patients trying to understand their healthcare costs.

Several Kansas City-area hospitals were cited for non-compliance in certain areas in the report. However, the hospitals in question, as well as the Missouri Hospital Association, maintain that they adhere to the more limited sampling conducted by the Centers for Medicare and Medicaid Services (CMS).

Disagreements Over Compliance

Several hospitals took issue with the PRA’s report. Children’s Mercy Hospital, North Kansas City Hospital, and Saint Luke’s Hospital Kansas City all disputed the group’s findings, insisting that they are compliant with CMS standards.

The PRA report also indicated that files for Research Medical Center, Centerpoint Medical Center, and Lee’s Summit Medical Center, all part of the HCA Midwest hospitals, failed to provide adequate information. While the HCA Midwest spokeswoman stated that their hospitals had implemented the federal requirements, the files have since been updated on the HCA Midwest website.

Transparency in Healthcare Pricing

The 2021 rule to clarify hospital prices was an attempt to remove uncertainty surrounding hospital costs. However, the PRA has expressed concerns whether these transparency files are properly accessible and include information to the letter of the law. A 2023 analysis by KFF found that hospitals are inconsistent with where price transparency information is on their websites and how files are organized.

If hospitals were to organize their files correctly, Fisher argued, it would become much easier for consumers to compare the cost of different treatments and weigh them against the cost of a cash payment. With better accessibility and digital solutions, the search for hospital services could become as easy as searching for flights online.

Penalties and Further Legislation

Starting last year, the Biden Administration increased possible fines for failing to comply with the price transparency regulation. However, of approximately 5,000 U.S. hospitals, action has been taken against only six, with eight more under review – none of these are in Missouri.

State Representative Aaron McMullen has stated that a bill has been filed in Missouri that would expand upon current state hospital price transparency laws.