WASHINGTON — Louisiana Sen. Bill Cassidy is leading a bipartisan effort to craft legislation mandating greater price transparency from hospitals, clinics and other health-care providers.
Cassidy and six other U.S. senators penned a letter to a wide range of groups involved in the health-care industry asking for feedback on potential approaches to offering patients and families more information about the cost of medical procedures and tests.
Cassidy, a Republican physician who practiced medicine for years before turning to politics, has for years set his sights on the oft-hidden prices charged by hospitals, clinics and drug makers.
Cassidy has backed previous efforts to require greater disclosure of prices, which he's argued would allow market competition to bring down costs and give patients the ability to compare fees charged by different providers for the same service beforehand.
"If somebody's got a $6,000 deductible, they should know the cash price," Cassidy said. "If they know the cash price beforehand, they get a better price; and if they wait to find out later, they get the undiscounted price that's oftentimes 3-to-10 times higher."
Health-care service providers rarely disclose publicly the prices charged for supplies and procedures, in part because insurers and providers frequently negotiate discounts and deals individually. That's left some patients who pay out-of-pocket shocked by massive bills from hospitals or clinics for some tests and procedures.
Cassidy said he recently came across the story of one patient charged $17,000 for a urine drug screening — a common and routine test — and has tracked other "horror stories" of families stuck with unexpectedly steep bills.
Vox Media, a left-leaning news outlet, has tracked wide disparities in the prices charged by different health-care providers for the same services as part of a project analyzing emergency room bills, including a $16,000 fee for a single CAT scan at one California hospital.
"That needs to be upfront: How much does it cost and do I want to pay for it?" Cassidy said.
The letter — which Cassidy wrote with Republican Sens. Chuck Grassley of Iowa and Todd Young of Indiana and Democratic Sens. Claire McCaskill of Missouri, Tom Carper of Delaware and Michael Bennet of Colorado — poses a dozen questions to health-care groups, advocates and think tanks.
"We all agree that healthcare costs are too high and now it is time to move towards a system that is more open, efficient and accountable to the needs of the modern patient," the senators wrote in the letter.
Previous efforts to mandate greater price transparency faced pushback from hospital groups and drug manufacturers, some of whom have argued that publicly disclosing pricing undermines the ability of insurers to negotiate discounts.
Paul Salles with the Louisiana Hospital Association said Friday the group was still reviewing the letter's questions and soliciting feedback from its members. But Salles noted the state's hospitals launched a website, www.LaHospitalInform.org, in 2006 to provide information about common in- and out-patient services.
Cassidy said he'd hoped to roll out broader legislation aimed at increasing price transparency on medical services and pharmaceuticals, but signed onto the letter in an effort to build the kind of bipartisan support needed to pass any changes into federal law.
A 2011 Government Accountability Office report found that the proprietary nature of contractual agreements between insurers and health-care providers — as well as anti-trust concerns — posed potential obstacles to price transparency efforts.
The report also found that legal limits on access to information — including patient and claims data — also presented challenges.
But giving patients up-front information about how much hospital or clinic services are going to cost could bring down prices by encouraging patients to push back on tests or procedures that aren't urgent or necessary, said Devante Lewis, federal policy advocate for the Louisiana Budget Project, a left-of-center group that advocates for low- and moderate-income families.
"We are extremely pleased to see Sen. Cassidy working on legislation that empowers consumers and focuses on providing better coverage," Lewis said. "This is an initiative that will help all in health-care and make it more affordable, efficient and transparent for the average consumer."
Cassidy acknowledged his proposals could spark serious opposition from some influential health-care groups. But Cassidy said he's convinced that pulling back the curtain on what medical services cost is in the interest of his constituents.
"Of course there are some people that gain power by not being required to show their price," Cassidy said. "But who cares? It's about the patient, it's about the family, it's about the individual."