Report claims Blessing failing to comply with price transparency law, but hospital officials disagree

QUINCY — A report from Patient Rights Advocate says less than half of Illinois hospitals are transparent with their pricing, despite a law passed three years ago requiring them to post all prices online.

On the list of hospitals failing to comply is Blessing Hospital in Quincy. However, officials at Blessing Health System said in a prepared statement they believe it is in full compliance with federal price transparency laws.

Patient Rights Advocate, headquartered in Massachusetts, is a 501(c)(3) nonprofit organization. The mission on its website says it is focused on “ushering in systemwide healthcare price transparency.” Cynthia A. Fisher is the founder and chairman.

The Centers for Medicare and Medicaid Services (CMS) issued a rule effective Jan. 1, 2021, to improve transparency in healthcare costs by requiring hospitals in the United States to make public its standard charges for items and services it provides.

Certain hospitals, such as military treatment facilities, are deemed by CMS to have already met requirements. The remainder are required to make their standard charges public in two ways:

• a consumer-friendly display comprising at least 300 shoppable services, which can be satisfied through the release of a shoppable services file or by offering a price estimator tool.
• a comprehensive, machine-readable file.

Patient Rights Advocate says 94 percent of Americans support healthcare price transparency, but it claimed in its semi-annual Hospital Price Transparency Report published in February that only 34 percent of hospitals nationwide and 39 percent of hospitals in Illinois comply with the hospital price transparency rule. The report claims it reviewed 2,000 hospitals nationwide, with 689 found compliant. The report looked at 74 hospitals in Illinois.

“We have the right by law, for three years, to know these prices, and hospitals and insurance companies have been blocking it by making it too difficult,” Fisher told WCCU-TV, a Fox affiliate from Urbana. “When we look at compliance, we look at the rule of the law which requires all prices, by every insurance carrier, every health plan the hospital accepts, to be posted by every procedure and every procedure code clearly named.”

The statement provided by Blessing Hospital says all required information is accessible to the public through its price transparency webpage. At the bottom of that page is a link to the Blessing Hospital price list.

“In the event someone is unable to find what they are looking for on the Blessing price transparency website, they are encouraged to call the Patient Financial Services department at Blessing Hospital in Quincy, Illini Community Hospital in Pittsfield or Blessing Health Hannibal in Hannibal, Mo., for assistance in locating the information they seek on our webpage,” Blessing’s statement read. “The telephone numbers of those departments are listed on the webpage.

“Additionally, Blessing goes beyond the minimum price transparency standards because we feel a personal conversation is the best way to create a true understanding of a financial obligation and reduce confusion and frustration. Blessing has a robust team of financial counselors. Using the phone numbers listed on our price transparency website, a counselor can be contacted to provide a one-on-one personalized price estimate. Also, if an individual prefers to handle this online, a price estimate form is available on this same webpage.”

A statement from Molly Smith of the American Hospital Association says the Patient Rights Advocate report “blatantly misconstrues, ignores, and mischaracterizes hospitals’ compliance with federal price transparency regulations.” The Centers for Medicare & Medicaid Services reported in 2022 that 70 percent of hospitals had complied with both federal requirements and more than 80 had complied with at least one.

Cleverley and Associates, a hospital financial consulting service based in Ohio, said in a report filed Monday that Patient Rights Advocate’s findings “continue to be horribly flawed.”

Fisher told WCCU that patients are probably paying much more than necessary if their hospital fails to comply with the price transparency rule.

“This is what we’re finding as we pull back the curtains and we look at the prices,” she said. “We’ve been finding that there’s a 10 times price variation on average in the same hospitals.”