From The Center Square: Another report reveals noncompliance by North Carolina hospitals on price transparency rule

Mission Hospital campus
According to N.C. Treasurer Dale Folwell, Asheville's Mission Health buries the full prices of its services on its website, in potential violation of federal transparency rules. Photo by Cindy Kunst

By Nyamekye Daniel, originally published by The Center Square. The Center Square is a project of the 501(c)(3) Franklin News Foundation, headquartered in Chicago.

(The Center Square) – State Treasurer Dale Folwell has doubled down on his stance against violations of hospital price transparency rules as new research shows several hospitals in North Carolina are not following the federal guidance.

Hospitals were required as of January 2021 to fully disclose online prices for services, unveiling negotiated rates between hospitals and insurers. The rule was implemented by former President Donald Trump‘s administration and was meant to help Americans compare medical service costs before seeking treatment.

According to a new report by the nonprofit Patient Rights Advocate, only 4 out of 21 hospitals reviewed in North Carolina followed the rules in 2021. The organization randomly checked 500 hospitals across the nation. Folwell is calling for federal and state officials to enforce the rule.

“We cannot wait for hospitals to willingly give up the profits reaped from secret contracts and hidden prices,” Folwell said. “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.”

After a Wall Street Journal report last year showed hospitals in North Carolina were defying the rules, Folwell urged the state attorney general and federal government to intervene. The journal examined more than 3,100 sites and found hundreds of hospitals, including Winston-Salem’s Novant Health, were using embedded codes to block access to their pricing lists. Folwell also revealed Asheville’s Mission Health buried its full price on its website.

N.C. Attorney General Josh Stein released a report in January that detailed a review of 147 hospitals in North Carolina. He said 122 hospitals were fully compliant with the rules. Stein said 16 hospitals were not compliant with the requirement they provide a machine-readable list of services and prices; one hospital was not compliant with the requirement it provide a consumer-friendly, shoppable list; and eight hospitals were not compliant with either.

The eight hospitals were Cherry Hospital Kindred Hospital in Greensboro, LifeBright Community Hospital of Stokes, Select Specialty Hospital in Durham, Select Specialty Hospital in Greensboro, Strategic Behavioral Center in Raleigh, Veritas Collaborative’s Adult Hospital in Durham and Veritas Collaborative’s Child and Adolescent Hospital in Durham.

Patient Rights Advocate found all six hospitals owned by Mission Health HCA failed to comply with multiple parts of the rule. Hospitals owned by Cone, Novant, UNC and Duke Health also were flagged as noncompliant. Mission HCA was among the fully compliant hospitals on Stein’s list.

“The majority of North Carolina hospitals are flouting compliance, harming employers and consumers,” Patient Rights Advocate founder Cynthia Fisher said. “Hospitals’ omission of comparative price information blocks consumers from benefiting from knowing the competition, seeking fair and equitable prices, and saving their money.”

The American Hospital Association has sued to stop the price transparency rule, saying it causes confusion about rates. The N.C. Healthcare Association argued it forces hospitals to reveal “trade secrets.”

Folwell said the rules “have exposed deep inequities in how hospitals bill patients.”

Folwell pointed out Atrium Health Wake Forest Baptist’s hospital in Winston-Salem charges $9,470 or $47,753 for the same appendix surgery, according to its records. Folwell said the price is dependent on the patient’s insurance coverage and “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,” Folwell said. “Then, when they can’t pay, they risk having their credit destroyed. Hospitals can’t continue putting profits before patients.”


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