The vast majority of hospitals across the country aren’t transparent about their pricing and Hawaii isn’t immune to that national trend, according to a new report by a national consumer advocacy group.

The nonprofit Patient Rights Advocate sampled 500 hospitals in the U.S. and concluded more than 94% aren’t complying with six-month-old rules that require hospitals to post certain price estimates online.

The rules requiring price transparency stem from a 2019 executive order by former President Donald Trump. President Joe Biden supports hospital price transparency as well and just this week proposed fining noncompliant hospitals up to $2 million annually.

About 6,000 hospitals are subject to the rule, but Patient Rights Advocate sampled 500. Their analysis included two Hawaii hospitals — The Queen’s Medical Center and Adventist Health Castle — and determined both haven’t yet met all the requirements of the rules.

The Queen’s Medical Center disputed that conclusion, telling Civil Beat that the hospital hasn’t been deemed noncompliant by the federal government and pointing to a price estimate tool on their website that the hospital said has been there since 2019.

Adventist Health Castle didn’t dispute the report and highlighted the efforts it’s making to come into compliance. Both hospitals emailed responses instead of making officials available for interviews on the subject.

Adventist Health Castle.
Adventist Health Castle said it will be publishing a new tool to help patients see the cost of various procedures next week. Cory Lum/Civil Beat/2021

The federal rules require hospitals to publish a slew of information on their websites to help consumers understand how much different procedures cost. That includes presenting charges for all hospital services in a machine-readable digital file and providing estimates in a consumer-friendly way for at least 300 services that patients can schedule in advance.

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Paul McDowell, chief financial officer of The Queen’s Health Systems, said in an emailed statement that the company has asked Patient Rights Advocate to correct the report, saying the hospital came into compliance prior to Jan. 1.

His statement said the hospital’s price estimator tool includes both the required prices and additional services selected by the hospital based on factors such as the likelihood people would look for the cost of the procedure.

“This tool is easy to use and provides all of the information a patient would need to determine their personal financial responsibility for services received at a Queen’s facility,” McDowell wrote.

Minna Sugimoto, spokesperson for Queen’s, said the price estimate tool can be found by going to The Queen’s Medical Center homepage, clicking on “Patients and Visitors,” navigating to the “Patient Tools & Resources” bar on the left, and clicking on “Patient Estimator.”

The Patient Rights Advocate report says while Queen’s does provide consumers with a machine-readable file of standard charges, the spreadsheet is missing the names of specific plans as required by the final rule.

Sugimoto said the plan names are available in the first row of the machine-readable file and urged patients concerned about pricing to contact Queen’s directly.

“We feel the website does meet the requirements and the information is there, but really the one-on-one contact is really how we feel we can best assist our patients,” she said.

Heidar Thordarson, Adventist Health Castle finance officer, said in a statement that Adventist Health will roll out a new price estimate tool for patients to see costs of medical procedures, excluding ambulatory services, on July 30.

The tool will be posted on the hospital’s website under the section “Patient Financial Services” and until then, patients who want price estimates or financial assistance can call 800-593-1551.

Janel Len, spokesperson for Adventist Health Castle said the tool will be initially focused on procedures patients most frequently ask about.

“We are looking to enhance the tool in the coming months,” Len said.

Cynthia Fisher, founder and chief executive officer of Patient Rights Advocate, said broad-based noncompliance is unsurprising given the national hospital lobby sued twice to prevent the price transparency rules from going into effect.

She believes price transparency is important because it will eventually allow consumers to shop for elective health care the same way they shop for airline flights.

“We’ll all get better care and have broader access at a much more affordable rate through these price transparency rules,” she said, adding the majority of health care involves planned rather than emergency procedures.

She said a Colorado college student who was recently charged $15,000 for an EpiPen contacted her nonprofit for help. Hospital prices posted online showed he could’ve gotten two EpiPens for $320, Fisher said.

“The hospital forgave everything within 13 hours from the time he put his letter forward,” she said. “This is how the power changes.”

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