(The Center Square) – Patient Rights Advocate says 60% of Wisconsin hospitals are not being honest about their prices.
A Wisconsin Hospital Association leader disagrees.
The report says hospitals, including dozens in Wisconsin, are not complying with federal regulations that require hospitals to be transparent with their prices.
“With full transparency, consumers can benefit from competition to make informed decisions, protect from overcharges, billing errors, and fraud, and lower their costs,” the report states. “Employer and union plans can use pricing and claims data to improve their plan designs and direct members to lower cost, high-quality facilities. However, continued noncompliance impedes this ability. The majority of consumers are still blind to upfront hospital prices, employer-sponsored health care premiums have increased 50% in the last decade, and 100 million Americans are in medical debt for charges they could not know in advance.”
The report looked at 2,000 hospitals across the country, 42 in Wisconsin. Joanne Alig, senior vice president of public policy for the Wisconsin Hospital Association, said that ignores thousands of other hospitals across the country, and more than 100 other hospitals in Wisconsin.
“There are over 150 hospitals in Wisconsin, but some of them are government hospitals that are exempt from the regulations, so there are about 145 that are subject to the federal requirement,” Alig said.
The report is also criticized in methodology and broad assumptions.
“They’re not unbiased,” Alig added. “They have called hospitals ‘extortionists,’ they have said hospitals are ‘waiting to prey on the uninsured.’ So, they really do seem to have a very narrow view.”
Alig said Wisconsin hospitals actually do quite well when it comes to price transparency, actual prices and the availability of care.
The Centers for Medicare & Medicaid Services, the agency charged with rating hospital price transparency, says the vast majority (70%) of hospitals across the country are compliant with the price transparency law. And even more (82%) are compliant with at least one aspect of that law. Almost all (91%) have prices posted online.
In Wisconsin, the Centers for Medicare & Medicaid Services said 38% of hospitals were rated five-stars in 2023, and 77% of Wisconsin hospitals were rated as either four or five-star.
A Forbes analysis ranked Wisconsin ninth-best of all 50 states in being the least expensive for health care.
“We certainly don’t want people to be concerned about accessing care because a report is telling them that hospitals are, you know, just out preying on them,” Alig told The Center Square. “Many of our hospitals have financial counselors and staff, they’re willing just to sit and talk through the kind of service, and what to expect, and what kind of price they can expect from the care that they’re going to get.”
Alig said there are concerns about the price of health care. She said it’s a much larger conversation than the report, with variables such as Medicare, Medicaid and insurance companies.
