New Jersey Star-Ledger Runs Joint PRA & SEIU 32BJ Op-Ed on the Price Transparency Solution

The New Jersey Star-Ledger ran a joint op-ed by Cynthia A. Fisher, founder and chairman of PRA, and Kyle Bragg, president of SEIU 32BJ. The piece explains how healthcare price transparency can eliminate widespread hospital price gouging by empowering consumers to shop for quality, less-expensive care. It highlights how the SEIU 32BJ Health Fund recently decided to drop New York-Presbyterian Hospital from its health plan network after its data showed that the system charges on average 358% more than Medicare for the same procedures. PRA and SEIU are part of a new price transparency effort called the Coalition for Affordable Hospitals.

Cynthia and Kyle write:

In these precarious economic times, it is critical we protect access to quality, affordable health care. That requires reining in hospital prices, which are the main driver behind the ever-escalating cost of care. Strengthening the federal price transparency law, which a final Biden administration rule released this month will do, is a good place to start. It will make it easier for healthcare consumers — including patients, unions, employers, and governments — to identify the best care at the best prices and significantly reduce their bills.

Recent Johns Hopkins University research published by Axios finds that the nation’s largest hospitals mark up their prices by an average of seven times their cost of care. A 2020 RAND Corporation report found that New Jersey hospitals charge an average of 228% of the Medicare rate for the same procedures. These costs have significant consequences for New Jersey residents, more than one-quarter of whom struggle to pay their medical bills and three-quarters worry about not being able to pay them in the future.

Healthcare consumers can already flex their purchasing power to combat out-of-control hospitals costs. The SEIU 32BJ Health Fund, which provides coverage to some 200,000 essential workers and their families across the Northeast, is doing just that. It recently decided to drop New York-Presbyterian Hospital from its health plan network after its data showed that the system charges on average 358% more than Medicare for the same procedures. What’s more, New York-Presbyterian routinely engages in anti-competitive contracting measures and refuses to publicly post its prices. By shopping with its feet, the Health Fund aims to deliver significant savings to its plan participants.

SEIU 32BJ is also working with New York lawmakers to pass statewide legislation that will improve price transparency and ban backroom contracting deals. If passed, this measure can serve as a model for other states and help North Jersey residents who choose to get care across the Hudson River.

Federal law mandates that hospitals publish all their negotiated rates by payer and plan as well as their discounted cash prices.

A recent analysis by PatientRightsAdvocate.org shows 94.4% of U.S. hospitals are noncompliant, including major New Jersey hospitals such as Hackensack University Medical Center, Morristown Medical Center, Robert Wood Johnson University Hospital, Saint Barnabas Medical Center and Valley Hospital.

All Americans deserve to see actual, upfront healthcare prices so they can avoid price gouging and choose quality, less-expensive care. As long as hospitals fail to comply with federal transparency requirements, consumers generally won’t know what they’ll be charged until after the bills have arrived weeks and months after care. By that time, it’s often too late to fight overcharges.

This lack of price transparency fosters widespread price variations for the same services — even at the same hospitals. In New Jersey, for example, the cost for an outpatient colonoscopy, according to Health Fund claims data, ranges from about $1,500 to $6,000 depending on what hospital administers the procedure.

Read the full op-ed in the Star-Ledger.