Why Should Delaware Care?
While Delawareans continue to spend thousands of dollars on health care year after year, a lesser-known rule about hospital pricing could save patients money prior to a procedure.
Hospital Price Transparency, a federal program launched during the first Trump administration, required hospitals to publicly post prices for common, pre-planned medical procedures, allowing patients to shop around to neighboring hospitals.
Implementation of the program took years, but today most hospitals in the mid-Atlantic region appear to be in compliance.
In this report, Spotlight Delaware has compiled the price transparency webpage information posted in recent years by Delaware’s top hospital systems, and those in nearby states.
As Delaware residents spend more on health care every year, understanding how much a procedure costs and where options may be cheaper could save someone thousands of dollars.
Earlier this month, Spotlight Delaware reported that health care spending in Delaware far surpassed analysts’ recommendations in 2023 for a third consecutive year. Data on 2024 health care spending has not yet been publicly released.
On a per-capita basis, Delawareans spent $10,588 on health care in 2023 – or about an eighth of the median gross household income for the state.
When implemented, price transparency was supposed to increase competition among hospitals and bring down costs for patients. But getting hospitals to be fully transparent has proven difficult, with a government watchdog report last year pointing to mass noncompliance across the country.
How do I find prices for my hospital?
All hospitals should have a tab on the homepage of their websites labeled “Price Transparency.” In most cases, hospitals tuck it away at the bottom of the site.
An easy way to find the tab is by pressing the control and F keys on your keyboard at the same time, then typing “Price Transparency.” Your computer should then jump to any part of the page that matches that search.
Every hospital has a different system for displaying their prices, with some offering tools to search online for various procedures, while others offer massive spreadsheets listing all self-pay prices and insurer-negotiated prices.
Most websites also offer an email or phone number to call, should someone have trouble finding a specific procedure.
Here are links to price transparency pages for Delaware’s top hospital systems.
Here are links to surrounding state hospital systems in Maryland and Pennsylvania.
What is price transparency?
Price transparency is a relatively new idea within hospitals, with it being fully implemented less than five years ago.
It requires that all hospitals publicly list prices for 300 of the most common, pre-planned procedures. Those prices should show self-pay options, as well as insurer negotiated rates in what a federal mandate calls a “consumer-friendly” format.
An additional component of the regulation requires hospitals to display prices in a “machine-readable file.” Pricing information should be accessible from a hospital website’s homepage, under a “Price Transparency” tab.
Should hospitals not be in compliance, they could be fined and publicly listed in a database of noncompliance.
During his first term in office, President Donald Trump signed a 2019 executive order aimed at increasing competition among hospitals, and bringing down health care costs for Americans.
In 2021, the Centers for Medicare & Medicaid Services (CMS) began enforcing new transparency rules.
In February after his second inauguration, Trump signed a second executive order telling the secretaries of Labor, Treasury, and Health and Human Services to “rapidly implement and enforce” price transparency regulations within 90 days of the order.
“Hospitals and health plans were not adequately held to account when their price transparency data was incomplete or not even posted at all,” the new executive order said.
According to the order, the secretaries will compel hospitals to display the complete price of a procedure, and not just estimates. On most hospital websites, they will list price estimates of the service but may not include additional physician charges, as well as other miscellaneous charges.
A 2024 report from the Office of Inspector General estimated that 46% of hospitals were noncompliant in the transparency effort.
“On the basis of our sample results, we estimated that 46 percent of the 5,879 hospitals that were required to comply with the [Hospital Pricing Transparency] rule did not comply with the requirements to make information on their standard charges available to the public,” the report said.
