Consumer group faults San Juan Regional Medical Center's pricing transparency effort

John R. Moses
Farmington Daily Times

FARMINGTON – A consumer advocacy group that monitors how hospitals are complying with the Price Transparency Rule targeted several New Mexico hospitals, including San Juan Regional Medical Center, saying they have remained non-compliant after 18 months of the law being in effect.

The head of that consumer group also wrote Gov. Michelle Lujan Grisham a letter detailing the group’s findings.

The group PatientRightsAdvocate.org (PRA) issued its third report on the issue Aug. 10. Their document “shows that 18 months after a law requiring hospitals to post their real prices online went into effect, a large majority of hospitals continue to hide the cost of care from consumers, including several from New Mexico,” the group said in a news release.

A Department of Health and Human Services office that accepts and investigates complaints has posted two official civil actions against two hospitals for lack of compliance, one in Atlanta, fined $883,180, and another in Canton, Georgia, that was hit with a $214,320 assessment.

“Hospital price transparency helps Americans know the cost of a hospital item or service before receiving it,” the federal government’s Centers for Medicare & Medicaid Services website CMS.gov states. “Starting January 1, 2021, each hospital operating in the United States will be required to provide clear, accessible pricing information online about the items and services they provide in two ways:

  • As a comprehensive machine-readable file with all items and services.
  • In a display of shoppable services in a consumer-friendly format.”

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“This information will make it easier for consumers to shop and compare prices across hospitals and estimate the cost of care before going to the hospital,” the site notes.

An inquiry to the Centers for Medicare & Medicaid Services about the number of pending non-compliance investigations was not answered by press time.

The consumer advocacy group reviewed SJRMC’s website and said SJRMC’s efforts were not good enough.

“The rule requires hospitals to publicly post a complete, machine-readable standard charges file for all items and services in addition to a price estimator tool,” Cynthia A. Fisher, founder and chairman of  PatientRightsAdvocate.org told the Daily Times via email. “Unfortunately, San Juan Regional Medical Center (SJRMC) has not made available its standard charges file, so the hospital is not in compliance with the rule. We are hopeful they will soon post all of their prices online so consumers can see and compare upfront prices.”

The hospital offered no direct comment on Fisher’s statement, but SJRMC spokesperson Laura Werbner pointed to several tools available online to help patients estimate the cost of health care at the facility.

“At San Juan Regional Medical Center, we are dedicated to meeting all federal and state requirements regarding price transparency,” Werbner said via email. “We believe that preparing in advance and knowing what to expect are keys to peace of mind when it comes to healthcare.”

“We provide pricing information when requested by our patients and placed price transparency information and pricing on our public website, www.sanjuanregional.com, in early 2019,” Werbner continued. “In addition, we added a user-friendly self-service patient estimate tool on our website in early 2022. The Patient Price Estimator can be accessed anytime here: https://sanjuanregional.patientsimple.com/guest/#/index.”

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Werbner noted that San Juan Regional Medical Center also “provides a ‘Good Faith Estimate’ to anyone who is interested in our services. More information can be found at: https://www.sanjuanregional.com/transparency/good-faith-estimate.”

The consumer group listed the following “key findings” from its national report:

  • Only 319 (16%) of hospitals examined were complying with the rule.
  • 101 hospitals (5.1%) did not post any standard charges file and were in total noncompliance.
  • None (0%) of hospitals owned by the two of the largest hospital systems in the country — HCA Healthcare and Ascension Health — are complying.
  • 18 of the 1,000 hospitals reviewed in February moved from compliant to noncompliant because removed they plan names from their files, and 97 previously noncompliant hospitals have become compliant.
  • The two hospitals that were recently assessed penalties from HHS for noncompliance are now fully compliant with the rule and have posted exemplary files.

The hospitals in New Mexico the group says are complying:

  • Eastern New Mexico Medical Center
  • Los Alamos Medical Center
  • Lovelace Medical Center
  • UNM Hospital

Fisher sent a letter to New Mexico’s governor recently noting the group’s findings.

“Once fully realized, systemwide healthcare price transparency will provide significant financial relief to patients and all consumers of healthcare: employers, unions, workers and taxpayers,” Fisher wrote. “In these inflationary times, the financial certainty of knowing real, upfront healthcare prices, along with the ability to shop, compare prices, and avoid price-gouging, constitutes the single most important action governments can take to dramatically lower the cost of care and coverage, while increasing access and improving quality.”

More information about Hospital Price Transparency, and a link for filing a complaint, can be found at the federal government’s Centers for Medicare & Medicaid Services website: https://www.cms.gov/hospital-price-transparency.

To read the consumer group's report go to https://www.patientrightsadvocate.org/