Texas Children’s provides new tools to optimize transparency for patient families

January 14, 2019

As one of the top ranked pediatric hospitals in the nation, many patients come to Texas Children’s to access our high quality care and services. While access to patient care is crucial, providing access to reliable and understandable price and quality information for patient and their families is important too.

The Centers for Medicare and Medicaid Services (CMS) issued a ruling that requires all hospitals to publish an online list of standard charges commonly referred to as a hospital chargemaster beginning January 1 of this year.

The chargemaster is used by hospitals to create a summary of charges and services, which are submitted as claims to health plans. Since the chargemaster only provides hospital charges, it does not help patient understand their out-of-pocket expenses. The chargemaster lists standard charges for procedures, services, supplies, prescription drugs and diagnostic tests, and fees associated with services such as equipment fees and room charges. A hospital’s chargemaster data also tracks service volume, costs and revenue.

When choosing the best children’s hospital for pediatric care, consumers should compare their out-of-pocket expenses coupled with important quality factors – like physician experience/expertise, research conducted, hospital quality and patient outcomes – to help guide them in their health care decisions.

The intent of the new CMS requirement is to make healthcare more like a retail experience when it comes to quality and price shopping. As one of the top five pediatric hospitals in the U.S., Texas Children’s strives to provide the best care possible with rates that are comparable to other pediatric hospitals.

“We are committed to transparency and want to educate our patient families regarding their financial obligations,” said Texas Children’s Director of Managed Care Kabby Thompson. “It is our responsibility to help our patient families understand the difference between cost, charges and payment, and we want them to also know what their out-of-pocket expenses will be before they come in for services.”

Besides making the chargemaster available on Texas Children’s website, the organization has created an online estimator tool to help families better understand what their unique out-of-pocket expenses will be based on their individual insurance/health plan. Texas Children’s began providing estimates to patients prior to their scheduled visits over five years ago, but this is the first time that patients can access this information online.

“We have worked really hard to make sure that our charges are competitive to what other children’s hospitals across the country have in place,” Thompson said. “While many other hospitals provide care to children, the breadth and depth of services at Texas Children’s, coupled with our proven outcomes, is not comparable to the vast majority of hospitals and systems. Texas Children’s has always acted in the best interest of children and families to ensure top quality health care services today and for years to come.”

Texas Children’s chargemaster and price estimator tool can be found on the Texas Children’s website by clicking on Billing and Insurance on the homepage.