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

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.

Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

1 Comment

  • Robert

    Chargemaster pricing is useless. Like the MSRP sticker on a new car, is not what you or your insurance company pays. You and your neighbor may pay a differrent price for the same procedure.

Notice: you are using an outdated browser. Microsoft does not recommend using IE as your default browser. Some features on this website, like video and images, might not work properly. For the best experience, please upgrade your browser.