RALEIGH — North Carolina State Treasurer Dale Folwell’s office has issued a new report detailing issues with the lack of transparency in pricing by hospitals in the state.
The report is titled “North Carolina Hospitals: Extreme Price Markups, Failures in Transparency for Shoppable Hospital Services.”
The data compiled in the report looks at hospital prices and hospital compliance with federal price transparency rules across 16 common shoppable services at 140 hospitals. Of those hospitals, only 51%, on average, disclosed their commercial insurance prices across the shoppable services. The disclosure rate dropped to 42% for cash prices on those services, and only five hospitals disclosed pricing for every service.
The new report follows the release of data by Folwell’s office showing that between January 2017 and June 2022, hospital systems in the state used the court system to extract more than $57.3 million in judgments by suing more than 7,500 patients over medical debt. In some cases, those patients didn’t even know they were being sued or that, in some cases, hospitals had placed liens on their homes.
According to a press release by Folwell’s office, researchers from the Johns Hopkins Bloomberg School provided data analysis based on June 2023 data from Turquoise Health, a software company that collects and displays hospital prices for patients and researchers to facilitate price transparency in healthcare.
Among the findings in the report are “extreme variations” in hospital pricing, large price markups on Medicare rates, and “widespread failures” in pricing transparency for treatment and procedures, as well as wide price disparities.
According to the report, the largest price disparities appeared in radiological services like CT and MRI scans, where hospitals were found to have inflated Medicare’s $108 rate up to $1,167, an increase of 976%.
The treasurer’s office ties the pricing disparities to the state’s Certificate of Need (CON) laws, which the U.S. Federal Trade Commission has blamed for increasing prices and anticompetitive behavior.
Other findings from the report include hospitals charging insured patients more than 700% of Medicare rates for some common shoppable services. An example given was a 1,120% median markup on a simple urinalysis test. Under that markup, patients paid a median of $28.80, while Medicare’s median was $2.36.
Among the uninsured, the costs were also inflated, with hospitals charging those patients over 150% more than Medicare rates for the shoppable services examined in the report.
The state Senate has already taken some action by unanimously passing the Medical Debt De-Weaponization Act this legislative session in an effort to combat pricing transparency and medical debt issues. The bill is awaiting action in the House.
