What you see may not be what you get

WORLAND – A new federal law requiring hospitals to post their prices doesn’t mean that consumers will actually pay the listed price.

Section 2718(e) of the Public Health Service Act, which was enacted as part of the Affordable Care Act requires all hospitals in the United States to make public, as of January 1, the prices of services offered.

But the public price advertised to the public may or may not be the price paid by consumers. According to a statement from Banner Health, who manages Washakie Medical Center in Worland, “It is important to remember that actual patient out-of-pocket costs are based on many factors, including individuals’ specific insurance plans and ability to pay. In addition to viewing our pricing resource page, we recommend patients talk with their insurance provider to fully understand expected out-of-pocket costs or they can also contact Banner’s pre-registration staff at their choice of hospital.”

The Wyoming Hospital Association (WHA) President Eric Boley stated, “It is important to note a patient’s financial responsibility may vary significantly from the posted charges depending on the type of insurance coverage he/she has, whether a service is covered in the plan, whether the provider is in the plan’s network, the plan’s cost sharing requirements, and if the patient is under their deductible. Uninsured patients will additionally see differences from the posted charges based on the hospital or provider’s offered self-pay discounts and/or sliding fee scales. Wyoming hospitals stand ready to assist patients in understanding what is being billed and their total out of pocket costs.”

While the actual out-of-pocket price may be different than the actual cost, healthcare providers feel that price transparency is important and good thing.

The Wyoming Hospital Association stated in a press release, “The WHA and its members believe patients have a right to know more about prices hospitals charge for services as well as information about how well hospitals are reimbursed for care they deliver, and how much of the care delivered is not reimbursed.”