Two years after federal rules first required hospitals to tell you what they’re charging for different services, one report suggests only 15% of Kansas hospitals hit the mark.

The consumer group Patient Rights Advocate’s February report found three of the 20 hospital systems that it reviews in the state — the organization focused on the largest hospital systems — fully comply with the federal price transparency rule. The group said several on the list were partially complying.

“We can count on what milk is going to be charged, or even eggs. We know eggs have gone up because of supply and demand. But we will know what those prices are,” Patient Rights Advocate founder Cynthia Fisher said. “It’s not like you find out what the dozen eggs costs, weeks or months later, and it’s 100 times more than you would have ever expected.”

The group’s report reviewed 2,000 hospitals nationwide and focused on the larger health systems in the country. The national rate of 25% of hospitals in compliance, by the group’s accounting, is almost double what it found in Kansas.

“We applaud those hospitals that are fully posting all of their prices,” Fisher said. “However, that shows you that the other largest hospitals in Kansas are flouting the law.”

The report strongly conflicts with a more limited sampling conducted by the federal Centers for Medicare and Medicaid Services. The government agency released a report this month that said 70% of the 600 hospitals it reviewed met the website assessment criteria. They include machine-readable files and consumer-friendly displays such as a price estimate tool. That marked a 27% improvement from what CMS found a year ago.

The Patients Right Advocate report shows that Centura Health, which runs two St. Catherine hospital locations in western Kansas, did not live up to the federal rules. That hospital group challenged the findings.

“We encourage our patients to request a patient-specific price estimate to help them determine their costs,” the organization said in a statement. “Additionally, Centura Health and our 19 hospitals are compliant with federal law regarding price transparency.”

Mercy Hospital in Columbus, Kansas, was also listed as non-compliant. But officials there say they have met all the CMS requirements.

“CMS determines hospitals’ compliance with these regulations, and while political groups continue to ask for new rules and regulation, they don’t set the requirements,” a hospital spokesperson said in a statement. “We stand by our transparency efforts, which are supported by the fact we acted quickly to correct a single request raised by CMS in 2021. We would do the same if CMS had other concerns.”

Turquoise Health collects data from hospitals and grades them on price transparency. It scores Centura’s St. Catherine-Garden City hospital five out of five stars and Mercy Hospital in Columbus two out of five stars on compliance. Centura’s St. Catherine-Dodge City does not have a scorecard.

Even when hospitals make the numbers available, they often do so in confusing ways. A recent analysis by the Kaiser Family Foundation found that hospitals are inconsistent with where the price transparency data is located on the website and how the files are organized.

“Even if there was a specific condition that the patient’s trying to price shop on, there’s a lot of times key information missing in the data,” co-author Krutika Amin said. “And when the data is available for the patient, it might be difficult to figure out what all different pieces go into the service that they’re seeking.”

Amin said to get a true estimate one might have to combine different costs that would be bundled in a medical bill but are listed individually online.

“It might take some maneuvering for even an expert to cobble together the pieces that make up the costs for care,” she said.

Missing codes also can make it difficult to know the difference in charges between inpatient and outpatient settings, Amin said.

Fisher, the Patient Rights Advocate founder, said CMS needs to enforce its rules more aggressively. The federal agency has sent warning letters to about 500 hospitals, but it has only fined two hospitals — both in Georgia in 2022. The two became compliant after they were fined.

Starting this year, the Biden Administration increased possible fines for failing to comply. They range from $300 to $5,500 per day.

Fisher said the first step in addressing high health care costs is making hospitals reveal prices easily readable by consumers.

“The only way we can get there is to be able to see the wide variety of prices that there are now and to comparatively see what’s happening across the state of Kansas on pricing,” she said, “and how that compares to adjacent states.”

Samantha Horton covers health care for KCUR and the Kansas News Service. You can follow her on Twitter @SamHorton5.

The Kansas News Service is a collaboration of KCUR, Kansas Public Radio, KMUW and High Plains Public Radio focused on health, the social determinants of health and their connection to public policy. 

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