Maria D. Cabrera is a city councilwoman at large and president pro tem in Wilmington.
When it comes to a medical emergency, Delawareans deserve access to affordable quality care. They also deserve to know whether medical procedures will cause them financial harm or land them in debt.
However, current trends amongst those with medical debts indicate just the opposite. There exists glaring disparities in the cost of hospital visits across the United States. In 2021, 50% of Americans reported having medical debt, and a 2019 study found 66.5% of all bankruptcies were tied to medical debt. Among the largest of the instigators of this debt on Americans were the hospitals themselves, with reports indicating that hospitals across the nation regularly engage in lawsuits and wage garnishments as a means of debt collection.
A potential solution to this lies in ensuring transparency with the cost of medical procedures.
Hospital services vary widely, and hospital pricing in general is opaque, making it nearly impossible for consumers to figure out what they might have to pay. In fact, the highest and lowest prices for standard outpatient services can vary by nearly 300%. When patients are unaware of the costs of medical procedures, specifically routine ones, they can be left with hefty medical bills. Between 2018-20, more than a quarter of the nation’s largest hospitals and health systems pursued nearly 39,000 legal actions for unpaid medical bills. It is worth noting that more than 65% of these hospitals were considered nonprofits. These effects are far-reaching in that they not only impact patients’ pockets but also lead to patients neglecting to seek future care out of fear of the potential costs.
In an attempt to address cost transparency, the Centers for Medicare & Medicaid Services now requires hospitals to publish the price of medical services that can be scheduled in advance. Unfortunately, despite this rule, many hospitals have yet to comply. A recent survey from patientrightadvocate.org found that only 14.3% of 1,000 hospitals surveyed were compliant with the rule. On top of this, even when hospitals do publish their prices, it can still be difficult for patients to know where to find them, how to read them and how to determine which charges they would be responsible for in any given treatment scenario. This sets the stage for unexpected charges and surprise bills.
Thankfully, efforts are underway right here in the First State. The Delaware Department of Health and Social Services recently launched a health care-transparency platform, called CostAware, which allows Delawareans to see for themselves just how invasive these cost variations are. While the site currently does not name any of the health care providers which provide the lowest cost services, an updated version is expected to be released in fall 2022, according to Delaware Health Care Commission executive director Elisabeth Massa. As CostAware continues to grow, it should become even more useful over time, with updated health care-cost data that empowers consumers and helps policymakers address the problem of cost disparities.
Transparency not only helps patients take control of their health care costs, but it also decreases prices in the long term by producing competition amongst health care providers. Achieving cost control through patient empowerment has received the support of policymakers on both sides of the aisle. Our lawmakers should enact steeper penalties for noncompliance to strengthen transparency mandates. Additionally, according to a recently published analysis, hospitals should also be required to present data uniformly, through a “machine-readable” template that complies with Centers for Medicare & Medicaid Services’ regulations.
Although this is no easy task, our policymakers should continue in their efforts to achieve quality transparency and effective pricing in health care. Local leaders and decision-makers must continue to advocate for greater patient empowerment. The health and well-being of Delawareans depend on it.
