NMC Commentary

Is There New Information on Charges on NMC’s Website?

Yes, as part of a new Federal requirement, hospitals now post their official “Charge Masters” on their websites in a format that can be imported into spreadsheets.  NMC has shared links to this information in the “Standard Charges” section on the “Cost of Your Care” portion of our website, located at: https://www.northwesternmedicalcenter.org/patients-visitors/pay-an-nmc-bill/cost-of-your-care/.  The “Charge Masters” list our standard charges for both hospital billable items/services and outpatient provider billable items/services. While we have complied with the requirement to post them online, honestly and unfortunately, I am not sure consumers will find it helpful for reasons I will discuss below. Therefore, if you have questions about what your care may cost, please call Brian, the Financial Counselor in NMC Patient Financial Services at 524-1006.

The intent of making the charges for medical care more transparent to patients is a goal NMC supports and works towards. In practicality, we find the best way to do so is by talking to individuals about their individual case, understanding their specific diagnosis, providing an estimated range of what might be included in their care, and then helping them understand what portion of that their particular insurance will cover and what will remain for them.  The challenge of simply posting charges within the US’s fee-for-service system is the complexity. NMC is a comparatively small organization nationally and our Charge Masters still contain 11,208 individual charges which might pertain to a particular case – depending on what the exact diagnosis is, what the provider’s approach is, and what supplies are used in the care. To add to the complexity, nearly no one in the US system pays the amount from the Charge Master. Medicare, Medicaid, and commercial insurances all have different approaches to how and what they will pay and what portion is the responsibility of the patient. Even those individuals who are paying without insurance often do not pay what is listed in the Charge Master, as NMC’s own guidelines for providing financial assistance to our patients extend up to 300% of the Federal poverty level (which is approximately $75,000 per year for a family of four).

Fundamentally, the new Federal regulation is trying to help consumers understand the price of their care, preferably in advance of receiving that care. Vermont already has a similar state requirement, one that publishes a comparison of charges among Vermont hospitals at the admission or procedure level for the most common inpatient and outpatient cases at each hospital. That information is available on the State’s website via a link in the “How Do NMC’s Charges Compare Statewide” of the web link provided above. For example, here you can see that NMC’s charges are below the State average for all of the 33 inpatient major diagnosis codes published by the State and you can see where we vary in other areas. This may be a bit more useful for consumers, but these are still the list charges, which again, do not truly reflect exactly what an individual may pay given their unique circumstances and their insurance coverage.

We do hope posting this data is helpful. Even more so, we want to help you get the information you need to make informed decisions about your healthcare. If you have questions, please call us. For information on charges and coverage, please call Brian, our Financial Counselor in Patient Financial Services, at 524-1006. At the same time, please be assured that NMC and Vermont’s other not-for-profit hospitals are working to navigate healthcare reform to bring about a more understandable and predictable system based on population health rather than the old-fashioned fee-for-service approach.

— Jill Berry Bowen, RN, NMC’s Chief Executive Officer