Hospitals are required by federal law to disclose previously confidential prices to consumers, but companies are taking steps to hide that information from search engines.
During the Trump administration, a new federal health care rule was issued that required hospitals to publicly post prices for every service they offer and break down those prices by component and procedure. The rule is called “Transparency in Coverage,” and was created with the intention of allowing consumers to see the pricing options at different hospitals and to choose where to go based on pricing considerations.
Pricing at different hospitals varies greatly. The New York Times reported that a simple blood test can cost $11 or $1,000. Coronavirus tests have similar sharp price variations, with prices ranging from $27 to $2,315.
The American Hospital Association filed a lawsuit against the Trump administration’s rule, claiming the administration did not have the legal authority to require the publication of negotiated prices, arguing that the publication of the hospitals’ prices could have perverse effects. However, the group lost the lawsuit, and the transparency rule went into effect.
Despite the win in court for transparency, hospitals are continuing to fight disclosures by hiding prices from web searches. According to The Wall Street Journal, hundreds of hospitals embedded code in their websites that prevented Alphabet’s Google and other search engines from displaying pages with the hospitals’ price lists.
The examination found that more than 3,100 sites were hiding their prices from search engines. Consumers can still find the prices, but they must click through multiple layers of pages and links for most sites.
“It’s technically there, but good luck finding it. It’s one thing not to optimize your site for searchability, it’s another thing to tag it so it can’t be searched. It’s a clear indication of intentionality,” said Chirag Shah, an associate professor at the University of Washington who studies human interactions with computers.
The Wall Street Journal found the price hiding computer code in some of the biggest U.S. healthcare systems and the largest hospitals in cities like New York and Philadelphia. These hospitals include those owned by HCA Healthcare Inc., Universal Health Services Inc., the University of Pennsylvania Health System, and NYU Langone Health.
A study in early March 2021 found that only about a third of America’s 6,000 hospitals had fully complied with disclosure requirements. Part of the problem with compliance identified by the study was the lack of regulatory incentive associated with disclosures.
The penalty for noncompliance is only $300 per day— a low cost for hospitals where the penalty can be easily covered by a single NICU visit. By not complying, hospitals can avoid the overhead and expense required to create public data files disclosing service costs.
The study also showed that noncompliance allows hospitals to continue keeping their rates hidden from not only consumers but also competing healthcare providers in their service areas which allows them to preserve their current pricing strategy and market dynamics.
Hospitals that have utilized the blocking code identified by The Wall Street Journal claim that they are doing so to direct patients first to information they consider to be more useful than raw pricing data or to disclosure statements.
When The Wall Street Journal approached a number of the hospitals involved, some of them removed their search blocking codes and an HCA spokesman claimed the code was left on the website by mistake.
