According to an investigation by the Wall Street Journal, hospitals that disclosed their previously confidential prices under the new federal rule have also blocked that information from Internet searches through a special code embedded in their websites.
The information must be disclosed under a federal rule aimed at making the billion-dollar industry more consumer-friendly. But hundreds of hospitals have placed code on their websites that does not allow
Alphabet Inc.
GOOG 0.34%.
Google and other search engines do not display pages with price lists, according to a study of more than 3,100 sites.
According to the computer scientists, the code prevents the pages from showing up in searches for, for example, the name of the hospital and the price. Prizes are often available in other ways, for example. B. via links, which may require navigating through different levels of pages.
Technically, it’s there, but good luck finding it, he said.
Chirag Shah,
an associate professor at the University of Washington who studies human-computer interaction. It’s one thing to not optimize your site for search engines, it’s another thing to tag it in such a way that it can’t be crawled. This is a clear indication of intent.
Coding switch
Many of the hospital websites on which the Wall Street Journal published information about mandatory pricing contained lines of code that prevented the sites from displaying in searches. After the Journal contacted hospital operators, some of them removed the piece of code from their websites. Example:
Methodist Health Care in San
Antonio’s website* 11. March
By adding a piece of code to the HTML header, the site owner made sure the page didn’t appear in the search results.
From 15. March, the code snippet was no longer available. A company spokesperson said the search blocker was old code that we removed.
Methodist Health Care in San
Antonio’s website* 11. March
By adding a piece of code to the HTML header, the site owner made sure the page didn’t appear in the search results.
From 15. March, the code snippet was no longer available. A company spokesperson said the search blocker was old code that we removed.
Methodist
Medical care in San
Antonio’s website
11. March.
By adding a piece of code to the HTML header, the site owner made sure the page didn’t appear in the search results.
From 15. March, the code snippet was no longer available. A company spokesperson said the search blocker was old code that we removed.
Methodist Health Care in San Antonio
Website* 11. March
By adding a code snippet to the HTML header, the site owner made sure the page didn’t appear in search results.
From 15. March, the code snippet was no longer available. A company spokesperson said the search blocker was old code that we removed.
The websites on which the Journal found the blocking code included those of some of the largest U.S. health systems and some of the largest hospitals in cities like New York and Philadelphia. These include hospitals owned by
HCA Healthcare Inc,
HCA 0,30
Universal Health Services Inc,
UHS -0.91%.
the University of Pennsylvania Health System and the State University of New York Langone. Some regional systems also had this code on their websites, including Beaumont Health in Michigan and Novant Health in Winston-Salem, North Carolina.
Penn Medicine, NYU Langone and Novant Health said they used blockchain code to direct patients primarily to information they deemed more useful than raw rate data, for which they also included links. Universal Health uses a lock code to ensure consumers confirm the disclosure statement before viewing prices, said Jane Crawford, spokeswoman.
We make no effort to hide information, Crawford said in an email.
After the Journal contacted hospitals about the findings, the search blocking code was removed from sites like HCA, Penn Medicine and Beaumont, as well as Avera Health in South Dakota, Ballad Health in Tennessee, Health in Northern Maine and Gundersen Health System in Wisconsin.
A spokesman for HCA said the search blocker was old code that we removed. Avera, Ballada, Beaumont and Northern Lights said the code was left on their websites by mistake. A spokesman for Gundersen Health System said the code was inserted by a website provider. The reason is unclear, he said.
Computer scientists say this code can be used in web page design to prevent search engines from saving an incomplete copy as a backup, called a cache copy. Usually the code is removed when the page is finished, experts say. Some hospital carriers have reported that they have recently finalized their pricing data pages to comply with the rule.
ThePennsylvania Hospital in Philadelphia, shown last March, is one of the hospitals that have a code that hides price search results.
Photo:
Jessica Kourkounis/Reuters
Hospitals must disclose information about prices they have long kept secret to comply with a federal rule that went into effect Jan. 1 as part of the Trump administration’s push for greater transparency in health care prices. The rule discloses for the first time the prices at which insurers negotiate for many hospital services.
These prices are opaque, even to the employers and consumers who pay for the coverage, and can vary widely depending on who pays them.
According to federal officials who drafted the decision, the data can help consumers find the best deals and help doctors and employers choose which hospitals to refer their patients to for care.
The use of a lock code is a way for hospitals to get around the rule’s requirements, according to experts on the new rule.
They take proactive steps to find something more difficult, it is said.
Thomas Barker,
a health care attorney at Foley Hoag and former employee of the Department of Health and Human Services. I would say that is contrary to the spirit of the rule.
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The rule requires hospitals to publish prices for all services. Hospitals typically have a rate sticker that can serve as a starting point for the rate reductions they negotiate with insurers. Hospitals also have prices to pay for the uninsured. The new regulation requires that these rates, in addition to insurers’ prices, be made public.
The rule also requires that the database of all rates be posted prominently on a public website and that the hospital ensure that the data is easily accessible and barrier-free.
Hospitals that violate this rule risk fines of up to $300 per day.
We expect hospitals to comply with these requirements and enforce these rules so that Americans know in advance what the cost of their health care will be, an HHS spokesman said.
The slow pace of implementation is frustrating for employers, researchers, and startups that want to use price information to develop tools for consumers. Officials overseeing New Jersey’s employee health plan, which covers about 800,000 people, wanted to compare their benefits to other health plans. They abandoned the project because the data was not good enough, they said.
Christina Deacon,
Director of health insurance. Officials have encountered a frustrating patchwork of voluntary noncompliance and attempts at compliance that do not meet the spirit of the rule, she said.
To identify websites hidden in search results, the Journal wrote a program that read the content of 3,190 disclosed sites whose addresses were provided by Turquoise Health Co, a startup that works with price transparency data. The program looked for a tag in the background coding of pages that tells search engines not to index the page.
The Journal found 164 websites with disclosure records for 307 hospitals that contained versions of this blocking syntax. Some pages contain information about more than one hospital in the system. The code was removed from the data pages of 182 hospitals after the Journal contacted the owners.
Turquoise, who since 1. Janvier searched for pricing information on U.S. hospital websites and found that many facilities did not comply with the new rule. About 45% of the 2,267 short-stay hospitals, children’s hospitals and rural hospitals that Turquoise has reviewed to date scored three or higher on a five-point compliance scale. Many poorly rated hospitals reported only procedure prices, not the actual rates negotiated with insurers.
NYU Langone is one of those hospitals that only announces prices. We continue to do our best to meet the new requirements, a NYU Langone spokeswoman said.
Houston Methodist does not publish negotiated rates. The eight-hospital system publishes retail prices and average costs for certain inpatient services, but the pages containing those files are embargoed. A spokesman said Houston Methodist believes listing negotiated rates would be confusing and misleading. Available pricing data can be found by searching the web, she added. The adjacent page is displayed in the search.
Some hospitals put prices in places on their website where you have to scroll or click for a long time to get there. Computer experts say this can make it harder to find information.
The number of clicks or scrolls required to complete an action is not a bad indicator of how many people will come, he added.
Ben Schneiderman,
Professor emeritus of computer science at the University of Maryland.
UPMC, a 40-hospital system in Pittsburgh, posted price lists on each hospital’s website, which can be accessed with seven clicks through UPMC.com. The user clicks on the Locations, Hospitals, Patients and Visitors and Patient Information links to access them. UPMC, which removed the lock code from the pages of pricing data for both hospitals after the Journal published it, did not include commercial prices negotiated for insurers in its data. The health system provided other data required by the rule, such as item prices and co-payments.
A UPMC spokesperson said the site’s navigation is in line with that of other health systems and it only takes three clicks to access data on individual hospital websites. UPMC is watching how other hospitals and regulators respond to the rule’s requirements, he said. The lock code was accidentally found on the hospital’s pages, he said.
-Rob Barry contributed to this article.
E-mail Tom McGinty at [email protected], Anne Wilde Matthews at [email protected] and Melanie Evans at [email protected].
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