Alan Bavley

A healthy dose of clarity in Missouri

Updated: 2014-01-22T04:58:04Z


The Kansas City Star

Anyone who has tried to make sense of hospital charges may feel they have more in common with numerology than with accounting.

It doesn’t have to be that way. Some states collect price information from hospitals and post it online. It could even happen in Missouri.

Sen. Jason Holsman, a Jackson County Democrat, has introduced a bill that would require hospitals and outpatient surgery centers to start reporting their charges to the Department of Health and Senior Services next year. The health department would post the charges for each facility in a consumer-friendly fashion on its website.

Hospitals would provide their charges for the 100 most common reasons for admission. And not just their “chargemaster” prices, the hyperinflated, fantastical list prices that bear little resemblance to what most patients actually pay. Hospitals would have to divulge the average real-world prices they negotiate with insurance plans and uninsured patients.

In like fashion, outpatient surgery centers and hospital outpatient departments would have to report charges for the 20 most common surgical and 20 most common imaging procedures.

Holsman modeled his bill after a North Carolina measure signed into law last August. New Hampshire and Massachusetts have laws doing much the same thing.

“Health care is the only industry where you consume the services and don’t find out the costs until weeks later,” Holsman told me. By putting price information in the hands of consumers, “we have a shot at driving costs down.”

The state’s hospitals haven’t taken a formal stand on Holsman’s bill.

“We realize that the system is broken. And we’re committed to working with other providers, insurers and stakeholders to improve transparency,” Missouri Hospital Association spokesman Dave Dillon said in an email.

But any transparency discussions ought to involve not just hospitals but other significant players such as physicians and insurance plans, Dillon said.

That might yield more information for consumers. But it also would make for more complex legislation and a formidable array of interest groups to reconcile.

Dillon pointed out that Missouri hospitals have been filing charge data with the state for 22 years. True, but the state doesn’t make charges of individual hospitals publicly available as Holsman envisions. The last state publication that did so that I could find was a $3 booklet from 1994.

Maybe after two decades of health care inflation, growing consumer interest and widespread adoption of the Internet, an update is in order.

To reach Alan Bavley, call 816-234-4858 or send email to

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