Indiana hospitals are falling short of federal requirements to make their pricing information publicly accessible, leaving patients in the dark about the cost of medical services.
A federal rule that went into effect in 2021 requires hospitals to post clear, accessible pricing online for common services, but a recent report by Patient Rights Advocate (PRA) reveals that many Indiana hospitals are not meeting this standard.
Noncompliance ranges from incomplete data to entirely missing pricing disclosures, raising concerns about the lack of transparency and its impact on patients’ ability to make informed financial decisions.
Cynthia Fisher, founder and chair of PRA, runs the nonprofit dedicated to making sure consumers know the prices of health care up front.
“We know that price transparency protects patients from overcharges and overbilling,” Fisher said. “We’re finding that prices vary by 10 times in same hospitals on average, and, across hospitals in the same state, we’re seeing price variation on average 30 times (for the same service).”
According to the Kaiser Family Foundation 2024 census on medical debt, approximately 14 million people (6% of adults) in the U.S. owe over $1,000 in medical debt. In October, the Biden-Harris administration announced new actions to reduce this debt and address illegal medical debt practices.
“No one should be denied economic opportunity because they got sick or experienced a medical emergency. That is why I have worked to cancel hundreds of millions in medical debt to date — part of our Administration’s overall plan to forgive $7 billion by 2026 — and make it so medical debt will soon no longer be included in your credit score,” Vice President Kamala Harris said.
The PRA report revealed that only 11% of Indiana hospitals comply with the rule. The most compliant hospital in Indiana? Indiana University Health across the board.
“In our last report, we found Indiana had among the best price transparency in the country … and now we’ve found that hospitals are making it nearly impossible to find actual prices,” Fisher said. “Indiana has now fallen to the bottom of the list.”
In the last six months, according to Fisher, Indiana hospitals have been enabled to hide their pricing. The Centers for Medicare and Medicaid Services recently lowered transparency standards, which allowed hospitals and health care providers to omit dollars-and-cents prices.
“We know that the Biden administration allowed for obfuscation,” Fisher said. “The Biden administration increased the fines for hospitals for not showing prices to $2 million, but they did not enforce the law.”
As a result, Fisher said that hospitals obfuscate with percentages and formulas rather than revealing real prices to consumers. To push for change, Fisher and PRA wrote a detailed letter to President-elect Trump to ask that his administration reverse the trajectory and bring back transparent pricing.
“The Trump administration can insist on hospitals and the insurance companies showing all prices in dollars and cents,” Fisher said. “We are true purchasers, and it’s our money, it’s our health and money to save.”
Even without the enforcement of the pricing rule, Fisher maintains that patients can advocate for themselves beyond governmental oversight. Requesting an itemized listing of the bill, asking for a cash price and comparing medical billing to what your insurance company lists are all ways to lower the cost of a bill and hold hospitals accountable.
“We know of a woman who needed a drug, Flexeril,” Fisher said. “She went to the counter and was told that she would have an $85 copay for her 30-day supply. She knew it was an old drug off-patent and asked, ‘What is the discounted cash price?’ … It turned out the discounted price for that same drug was $15.”
While Indiana hospitals and hospitals across the country continue to hide pricing, Fisher maintains that every individual is capable of fighting for change, particularly when it comes to health care.
“We have to change our own behavior and take control of our wallets, our paychecks, our pocketbooks,” Fisher said.
This reporting is made possible by a grant from the Indianapolis African-American Quality of Life Initiative, empowering our community with essential health insights. https://iaaqli.org/
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Contact Health & Environmental Reporter Hanna Rauworth at 317-762-7854 or follow her on Instagram at @hanna.rauworth.
