Hospital association site unveils Web-based cost info

The New Hampshire Hospital Association last month launched a Web site that provides information about hospital charges for common services at the state’s 26 hospitals.

But what hospitals charge and what patients and insurers pay is another matter, and anyone who studies looking for information about out-of-pocket costs or the lowest priced hospital services in the state will likely be disappointed.

A charge is what the hospital lists for a service, but it is rarely what a patient or insurer pays. Actual prices vary depending on negotiations between the hospital and insurance companies, cost shifting to cover lower reimbursements from government health insurances, and free care.

While Mike Hill, president of the association, acknowledged that “few pay the charges” listed by hospitals, he said listing the charges moves the state in the direction of greater disclosure about health care costs.

“What will it cost me? That’s the one thing we can’t tell you,” said Hill.

Yet at first glance, consumers may not understand that charges listed on the Web site are not the same as hospital prices. What a patient pays depends on a number of variables, including some not available to the public.

“This is a starting point,” said Paul Gardent, chairman of the hospital association’s board and executive vice president of Dartmouth-Hitchcock Medical Center. “It’s important that you talk with your insurance company or the hospital to find out-of-pocket costs.”

Indeed, what patients pay for hospital services in New Hampshire depends on whether or not they have insurance, as well as the type of coverage. Costs also depend on hospital discounts and private negotiated agreements between hospitals and insurers – information that is closely guarded and unavailable to the public.

Consumers may use information on the Web site as a “guide” when talking with hospitals or insurance companies about costs, Gardent said.

Gardent and hospital association officials said they hope the new Web site leads to greater transparency in health-care costs. But Gardent said his hope for the future is a patient-specific resource, perhaps a calculator to help patients determine their actual costs.

New Hampshire is the third state in the nation to launch such a Web site; hospital associations in Wisconsin and Oregon have similar resources.

‘One piece of information’

During a noontime press conference at the hospital association in Concord, officials repeatedly used the words “transparency” and “starting point” to describe the Web site’s value. Health-care consumers now have information about hospital charges, including comparative data that previously was not easily available, officials said.

“This is only one piece of information for consumers,” said Kathy Bizarro, the association president, adding that the site links to, which provides information about hospital performance developed by the association-affiliated Foundation for Healthy Communities.

The state’s 26 hospitals, 13 small rural institutions and 13 larger ones volunteered to participate in the hospital association’s charges Web site.

Gardent said hospital administrators across the state were eager to participate in the project, believing consumer education about health-care costs can lead to “better discussions around health-care economics.”

Steve Norton, deputy director of the New Hampshire Center For Public Policy Studies, called the new Web site “an important step,” because it recognizes that health-care costs are “a primary driver of costs” in both the public and private sectors, he added.

Norton also acknowledged the Web site’s limitations.

“The information does not provide consumers with what they need to manage their pocketbooks as it relates to the cost,” said Norton. “It’s a step to open the door to transparency in the health-care market, not just hospitals, but all providers.”


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