GREEN BAY - It has been three years since a rule for hospitals went into effect requiring them to make health care costs public and readily accessible.
Prices are supposed to be listed online with a price estimator tool that lets patients look up the estimated costs for a treatment, according to the Centers for Medicare & Medicaid Service s .
However, if you tried to check out the cost estimates, you may get confusing results. Health systems report prices differently so it can be hard to compare costs between hospitals.
Help is on the way.
By July 1, all health systems will need to follow one format, under an update to the rule issued by the Centers for Medicare and Medicaid Services.
The hospital price transparency rule was issued under former President Donald Trump, who signed an executive order in June 2019 that made the requirement for hospitals to allow patients to choose which hospital to go to for care and eventually reduce costs through competition between health systems.
But there is still some confusion.
Some hospitals don't provide all types of costs in their list of charges or they are not listed by health insurance companies so it's hard to know how much a patient will actually need to pay. Currently, the disclosed prices show varying costs in northeastern Wisconsin, and even between hospitals in one health system.
Take for example the provided costs for a Level 4 emergency department visit, which is an urgent but not life-threatening visit. In a check of some northeastern Wisconsin hospitals, the prices do not include possible additional care, such as labs or imaging, during the visit.
In looking at hospitals in Appleton and Green Bay, under one PPO plan, the visit costs almost $900 at one hospital while it is $1,272 at another under the same plan. One hospital doesn't list the prices by insurance type.
Also, the spreadsheets may be hard to open in a way that is easily digestible.
To use the step-by-step estimator tool, instead of digging through the indigestible data, you'll need all your insurance information ready, including the name of your plan, deductible, and any coinsurance amounts. Though, the tool does not include estimates for all standard services. You may need to contact the hospital to ask for costs instead.
But it should be easier to compare the charges starting July 1 when the new regulations are in effect. Here's where you can find the price lists for each hospital.
How to look up prices for Green Bay hospitals
How to look up prices for Appleton hospitals
- ThedaCare Regional Medical Centers in Neenah and Appleton: Standard charges are listed at Thedacare.org by hospital name. Log in to your MyThedaCare account to use the cost estimator tool.
- St. Elizabeth Hospital: All Ascension hospitals are listed on the health system's Price Transparency page . Click "Estimate my price" and follow the steps to add your insurance information, treatment or service, and hospital location to determine your specific cost after insurance. A spreadsheet of all prices is also available.
- Children's Wisconsin Fox Valley Hospital: Visit MyChart/guestestimates to get prices or download the spreadsheet of standard charges .
Contact Benita Mathew at bmathew@gannett.com.
This article originally appeared on Green Bay Press-Gazette: Hospital prices hard to compare in Green Bay, Appleton; updated transparency law should change that July 1.
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