RALEIGH – State Treasurer Dale R. Folwell, CPA, has joined the national nonprofit Patient Rights Advocate to condemn the widespread violation of hospital price transparency rules. The treasurer is calling for federal and state action to fully enforce patients’ right to know hospital prices.
Under federal price transparency rules, hospitals must post their prices for consumers. These rules aim to empower consumers to shop for more affordable care, but new research shows that many hospitals have refused to publish their prices for patients. As a national nonprofit group focused on price transparency, Patient Rights Advocate analyzed 1,000 randomly selected hospitals across the nation, 21 of which were in North Carolina.
The study raises clear doubts concerning the compliance by certain North Carolina hospitals with federal price transparency rules. Only four out of 21 analyzed North Carolina hospitals complied with price transparency rules in 2021, according to a new national study by Patient Rights Advocate. Their research directly counters a recent report by Attorney General Josh Stein, who said he was “encouraged by North Carolina hospitals’ widespread compliance” with rules meant to “keep health care costs in check.”
According to Patient Rights Advocate, all six hospitals owned by Mission Health HCA failed to comply with multiple tenets of the rule, while hospitals owned by Cone, Novant, UNC and Duke Health were also flagged as noncompliant. The Attorney General graded Mission HCA as “fully compliant,” despite the systems’ failure to post any negotiated rates, according to the Patient Rights Advocate’s study.
“We cannot wait for hospitals to willingly give up the profits reaped from secret contracts and hidden prices,” said Treasurer Folwell. “Without price transparency, patients are left at the mercy of hospital billing departments. When state officials praise hospitals for breaking federal rules, patients are the ones who are punished by having to pay higher prices.”
The American Hospital Association sued to stop the price transparency rule, saying that it “does nothing to help patients understand what they will actually pay for treatment and will create widespread confusion.” The North Carolina Healthcare Association also objected, saying that price transparency would force them to reveal “trade secrets.”
North Carolina is facing a cost crisis. North Carolina is one of the most expensive states for health care in the nation. A starting teacher or trooper must work one week out of every month just to afford the family premium for health care. One in five families has a medical bill in collections. The cost of health care is not only punishing families but also robbing North Carolinians of their upward mobility.
“State Treasurer Folwell is a valued supporter of price transparency in the state of North Carolina. He understands that consumers need prices in advance of care to make the best health decisions and lower costs. The majority of North Carolina hospitals are flouting compliance, harming employers and consumers,” said Cynthia Fisher, founder of Patient Rights Advocate. “Hospitals’ omission of comparative price information blocks consumers from benefiting from knowing the competition, seeking fair and equitable prices, and saving their money. We applaud the four hospitals in North Carolina that are already fully complying with the Hospital Price Transparency Rule and hope the rest do so this year.”
The price transparency rules have exposed deep inequities in how hospitals bill patients. Patients are forced to pay wildly different prices even within one hospital. At Wake Forest Baptist’s flagship hospital in Winston-Salem, the same appendix surgery could cost $9,470 or $47,753, according to the systems’ chargemaster. These price tags are determined only by a patient’s insurance coverage — not by quality or complications.
“Health care is a product that people would rather not have to consume. When they must, and they ask how much it costs, they’re told it’s none of their business,” said Treasurer Folwell. “Then, when they can’t pay, they risk having their credit destroyed. Hospitals can’t continue putting profits before patients.”
Treasurer Folwell is calling on other elected leaders to join him in defending patients’ rights to know the price of their care. The treasurer wrote to the Centers for Medicare and Medicaid Services to urge greater enforcement of fines on noncompliance in 2021. CMS has not issued a single fine since then.
“The price transparency rules offer real hope for change,” Treasurer Folwell said. “Too many hospitals don’t want you to see their prices, but North Carolinians cannot afford to wait any longer. Federal and state leaders must act now to defend patients, instead of delaying enforcement or even obscuring the truth.”
The SHP, a division of the N.C. Department of State Treasurer, provides health care coverage to nearly 750,000 teachers, current and former lawmakers, state university and community college personnel, active and retired state employees and their dependents. For more information, visit the SHP website.