Shopping for surgery? Not all Fort Worth hospitals make it easy to figure out the cost

Say you need your hip replaced.

Under federal law, you should be able to “shop” for the hospital where the surgery would be the cheapest. You should be able to go to the website for the hospital closest to your house, and look up how much a hip replacement would cost there compared to the hospital across town.

But in reality, numerous Tarrant County hospitals are not in full compliance with the law, according to a Star-Telegram view of their websites. And, even if the hospitals were in full compliance, researchers have concluded that price transparency alone is not enough to keep the cost of a hip replacement at a reasonable price.

“Price transparency in and of itself does not do anything about the affordability and cost of health care,” said Krutika Amin, an expert on health policy with the Kaiser Family Foundation.

The law, which went into effect in 2021, requires hospitals to provide clear and public information about how much it charges both insurance companies and patients who are paying with their own money for the services the hospital provides. A second requirement, which went into effect last year, requires insurance companies to post the prices they’ve negotiated with hospitals and physicians.

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Together, these rules require information that has been kept secret for years to be made public.

But someone searching for a hip replacement in Tarrant County still might have trouble finding the price information they’re looking for.

For example, if you were to try and figure out how much a hip replacement would cost you at Medical City Fort Worth, you would have a difficult time getting a clear answer.

Medical City Fort Worth does post price information on its website. But most of the prices available are what’s known as the “list” price for a service like a hip replacement. The problem? Most patients don’t pay the list price. Instead, a hospital will charge the patient’s insurance company a price negotiated by the hospital and the company. The amount that the patient pays depends on what insurance plan you have. Your insurance company might cover the full cost, or you might be required to pay a co-payment or meet a certain amount, known as a deductible, before your insurance plan kicks in. Medical City Fort Worth’s data does include some of the prices negotiated between the hospital and insurers, but hospitals are required to list “all payer-specific standard charges, for all items and services with respect to all third-party payers,” according to the federal government.

Prospective patients at Medical City Fort Worth can get estimates of their cost if they provide their name, date of birth, and insurance information into Medical City’s online cost estimator tool. But federal regulations say access to information “may not require a log-in or password, other barriers, and/or the submission of any personal identifying information.”

In a statement, a spokesperson for Medical City Healthcare said “Our hospitals implemented the federal requirements in January 2021. Since then our hospital websites have included a consumer-friendly Patient Payment Estimator tool that provides relevant information to help patients understand what their out-of-pocket responsibility may be for hospital care, including those who are uninsured.”

The statement also said Medical City hospitals posted the “contracted rates” with insurance companies in a machine-readable file (like one you could sort in a spreadsheet).

Texas 2036, a nonprofit that advocates for greater transparency in health care among other issues, reviewed the websites of nearly 700 hospitals in the state in April. It found the majority — about 60% — were mostly compliant with the law, the highest rating the group gave in its in review.

But the researchers found fewer hospitals in the Dallas-Fort Worth health service region were in compliance.

A review by the group Patient Rights Advocate, which focuses on price transparency in health care, concluded that only 36% of hospitals it reviewed earlier this year were fully compliant.

But even if hospitals were complying, most researchers have concluded that price transparency alone won’t be able to significantly lower costs for patients or for the health care system as a whole, said Amin, who has been following the rollout of price transparency rules.

Part of the reason is because it can difficult for patients to “shop” for the cheapest hospital where they can get services. Patients might have few location that are within their insurance network, might be experiencing a medical emergency, or else might be referred to a specific location by a doctor they trust.

“Many times people don’t have the ability to shop for prices because it’s an emergent or urgent need,” Amin said.

An analysis from the nonpartisan Congressional Budget Office concluded that prompting price transparency would reduce prices for hospital services by less than 1%. The analysis found that a cap on prices would have a more significant impact on prices.

How easy (or hard) it is to find cost information for Fort Worth hospitals

Here’s how to track down cost information for some of the biggest hospitals and hospitals chains in Tarrant County. The price transparency law requires hospitals to post the information in two ways: As a machine readable file and as a “consumer-friendly” display. The information must be displayed “prominently” on a public website and must include the “list” charge, the negotiated charges for specific insurance companies or other payers, and the discounted cash price, according to the federal government. Federal regulations say the information should be accessible without the submission of any personal identifying information.

Medical City Healthcare: You can download cost information for hospitals that are part of the Medical City Healthcare network on its website, but the data does not include prices negotiated between the hospitals and insurance companies. You can also use the health system’s price estimator tool, but you must input your name, date of birth, and insurance information to do so.

Texas Health Resources: You can download cost information for most hospitals in the Texas Health Resources network on its website. You can also use THR’s online cost estimate tool, but you must input your name, date of birth, and insurance information to see estimates for insurance prices.

Baylor Scott & White Health: You can download cost information for hospitals within the network on the Baylor Scott & White website. You can also use the health network’s cost estimator tool, but you must input your insurance information to see cost estimates if you are insured.

Cook Children’s Health Care System: You can download cost information for Cook Children’s Medical Center on Cook Children’s website. You can use Cook Children’s online estimate tool, but must input your name, date of birth, and insurance information if you have health insurance.

JPS Health Network: You can download cost information from the health network’s website. You can also use the health system’s online cost estimator tool, but must input your insurance information if you have health insurance.