Medicare to post prices for common physician services

The AMA says true health care cost transparency also must include charges set by health plans.

By David Glendinning, AMNews staff. June 26, 2006.

Washington -- Medicare patients who always wanted to know what their doctors are paid for providing them medical services soon will get their chance.

The Bush administration has started what it hopes will be a new trend by posting on the Internet what the federal government pays for 30 of the most common elective procedures that Medicare beneficiaries receive at hospitals. It also will list payment for 11 of the most common types of nonelective services performed at the inpatient level.

The Centers for Medicare & Medicaid Services plans to expand the effort starting this summer to include procedures received at ambulatory surgery centers and beginning this fall to include physician offices.

President Bush said the initiative would allow Medicare enrollees and other health consumers to become more savvy about where they seek their care. Coupling these data with publicly available quality-of-care information, patients can seek out the best care at a lower price, he said.

"If you're worried about increasing costs, it makes sense to have price options available for patients," Bush told an American Hospital Assn. audience in a recent address. "That's what happens in a lot of our society. It should happen in health care as well."

The payment information CMS released at the beginning of June lists the range of what Medicare pays hospitals in a given county for such procedures as hip and knee replacements, cardiac defibrillator implantations and operations related to heart failure. The agency also lists the national average charge for each procedure based on what the hospitals list as the "walk-in" price. No hospital-specific payment or charge figures are included in the release, which is based on data from the fiscal year ending September 2005.