224:, Gerard F. Anderson observed, "Without knowing what services they will use in advance, it is impossible for patients to comparison shop." Anderson also noted the esoteric nature of the language on the chargemaster made it difficult for patients and anyone other than hospital administrators to understand. Anderson emphasized the difficulty of patients' ability to interpret the chargemaster in a subsequent 2012 article: "Furthermore, most of the items on the charge master file are written in code so that only the hospital administrators and a few experts in the field can interpret their meanings."
264:
236:
130:, "Charge-master rates, in reality, serve as nothing more than the starting point for negotiations" with the payer. The impact of the chargemaster is such that those with good insurance or better access to means to afford quality healthcare pay the least for that care, whereas conversely uninsured, and others who pay out-of-pocket for healthcare pay the full chargemaster listed price for the same services.
250:
216:
James C. Robinson pointed out prior criticism of the chargemaster, "Much ink has been spilt bemoaning that incomprehensible foundation of hospital cost accounting and prices, the redoubtable chargemaster." Robinson called for greater transparency as well as increased price standardization as steps to
141:
Hospital price transparency helps
Americans know the cost of a hospital item or service before receiving it. Starting January 1, 2021, each hospital operating in the United States will be required to provide clear, accessible pricing information online about the items and services they provide in two
103:
The procedure of developing, maintaining, and monitoring the chargemaster and its pricing scheme often necessitates multiple hospital employees working under the supervision of a "chargemaster coordinator", a "charge master manager", or others in the health care system's operations or administrative
182:
examined the overlooked role that chargemasters played in the
American health care system's cost crisis, asserting that they routinely listed extremely high prices "devoid of any calculation related to cost", and were generally regarded as "fiction" in the healthcare industry, despite their
183:
significant role in setting prices for both insured and uninsured patients alike. Then, a couple months later, the
Centers for Medicare and Medicaid Services published inpatient prices for hospitals across the country in a publicly available format.
92:. Each item in the chargemaster is assigned a unique identifier code and a set price that are used to generate patient bills. Every hospital system maintains its own chargemaster. Traditionally, hospitals regarded their chargemaster, alongside the
116:
analyzed utilization of the chargemaster and found that a low proportion of hospitals carried out regular reviews of their chargemaster implementation. Costs for patients maintained on the chargemaster differ greatly from hospital to hospital.
126:
73:
The chargemaster may be alternatively referred to as the "charge master", "hospital chargemaster", or the "charge description master" (CDM). It is a comprehensive listing of items billable to a
108:, compliance officer, and hospital Board. Approximately forty percent of hospitals pay outside companies to help create and then adapt their chargemasters on a yearly basis. According to
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with patients and health insurance providers of what amount of money will actually be paid to the hospital. It is described as "the central mechanism of the revenue cycle" of a hospital.
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support areas frequently called a "charge master team". Ultimate responsibility for ensuring accuracy of the chargemaster rests with each hospital's
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153:" (which is unique to the state) requires all hospitals to provide their chargemaster to the state, which then posts them online for the public.
172:
Chargemasters gained national attention in early 2013, when in short succession, there were two important publications made. First, there was a
1316:
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provider. It is described as "the central mechanism of the revenue cycle" of a hospital. Chargemasters include thousands of hospital services,
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that is central to their business, and state laws and courts have historically accepted the view that these are proprietary information.
164:, "Of particular importance, other than in Maryland, hospitals are generally free to charge whatever they want in their chargemaster."
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that the approach to chargemasters by hospitals would have to be modified to become more transparent, in order to encourage a form of
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186:"The 'full charges' reflected on hospital Charge Masters are unconscionable", wrote George A. Nation III in a 2005 piece for the
978:
476:
302:
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969:
Nation III, George A. (2005). "Obscene
Contracts: The Doctrine of Unconscionability and Hospital Billing of the Uninsured".
420:
178:
magazine cover story published
February 20, 2013, titled "Bitter Pill: Why Medical Bills Are Killing Us", in which reporter
1257:
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887:
862:
837:
806:
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659:
451:
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503:"Healthcare Information Division: Annual Financial Data – General Information About the Hospital Chargemaster Program"
1159:; Herring, Bradley (September 2012). "High US Health-Care Spending and the Importance of Provider Payment Rates".
1270:
625:
282:
719:
371:"The $ 2.7 Trillion Medical Bill – Colonoscopies Explain Why U.S. Leads the World in Health Expenditures"
205:
1275:
500:
112:, as of 2012 the chargemaster file typically included between 20,000 and 50,000 price definitions. The
1085:
946:"Hospital Prices No Longer Secret As New Data Reveals Bewildering System, Staggering Cost Differences"
1241:
1213:
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402:
179:
105:
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20:
720:"Errata Sheet for The Essentials of Managed Health Care, Sixth Edition, Jones & Bartlett"
651:
645:
191:
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Federally all hospitals are now required to post their chargemaster on the hospital website.
790:
269:
1113:
501:
State of
California Office of Statewide Health Planning and Development (August 8, 2012).
8:
996:
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50:
903:
825:
America's Health Care Crisis Solved: Money-Saving
Solutions, Coverage for Everyone
591:
560:"Those Indecipherable Medical Bills? They're One Reason Health Care Costs So Much"
88:, equipment fees, drugs, supplies, and diagnostic evaluations such as imaging and
1253:
949:
411:
255:
174:
469:
The
Comprehensive Review Guide for Health Information: RHIA & RHIT Exam Prep
1118:
1001:
200:
61:
to the hospital. The chargemaster typically serves as the starting point for
1305:
1180:
1132:
992:
571:
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1114:"From 'Soak The Rich' To 'Soak The Poor': Recent Trends In Hospital Pricing"
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1172:
1141:
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1024:
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317:
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97:
1292:, Office of Statewide Health Planning and Development, State of California
1126:(3). Project HOPE: The People-to-People Health Foundation, Inc.: 780–789.
688:
618:
Chargemasters: Strategies to Ensure
Accurate Reimbursement and Compliance
416:
113:
62:
1289:
997:"The Pricing Of U.S. Hospital Services: Chaos Behind A Veil Of Secrecy"
510:
146:
89:
19:
For the
British electric vehicle charging infrastructure company, see
533:"5 Things Hospitals Should Know About Their Chargemaster and ICD-10"
157:
74:
43:
77:
46:
793:
Health Care Management and the Law: Principles and Applications
235:
466:
54:
919:"Report: Surgery Prices Vary Wildly at California Hospitals"
58:
53:
provider. In practice, it usually contains highly inflated
788:
156:
The chargemaster procedure is generally only regulated in
1154:
133:
471:. Jones and Bartlett Publishers, LLC. pp. 49–51.
763:
42:), is a comprehensive listing of items billable to a
231:
743:. Jones & Bartlett Learning. pp. 114–115.
675:Schneider, Carl E. (July 2007). "The Cash Nexus".
1036:
1034:
1303:
1290:Database of hospital chargemasters in California
882:. Jones & Bartlett Publishers. p. 212.
1218:"Bitter Pill: Why Medical Bills Are Killing Us"
857:. South-Western College Pub. pp. 269–271.
789:Hammaker, Donna K.; Sarah J. Tomlinson (2010).
467:Tyson-Howard, Carla; Shirlyn C. Thomas (2009).
407:"Bitter Pill: Why Medical Bills Are Killing Us"
1298:, Centers for Medicare & Medicaid Services
1031:
1107:
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944:Young, Jeffrey; Kirkham, Chris (2013-05-08).
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732:
16:Chargeable items billed to a hospital patient
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821:
446:. Delmar Cengage Learning. pp. 41–43.
362:
343:"Revealing a Health Care Secret: The Price"
334:
308:Health insurance costs in the United States
1102:
968:
877:
764:Bartlette, Linda A.; Ida F. Lawso (2008).
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729:
596:Centers for Medicare and Medicaid services
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1058:American College of Healthcare Executives
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880:Managed Care: What It Is and How It Works
852:
846:
757:
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444:Comparative Health Information Management
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340:
1111:
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904:"Hospital Price Transparency | CMS"
822:Rooney, J. Patrick; Perrin, Dan (2008).
782:
768:. Nova Science Pub Inc. pp. 11–13.
639:
637:
584:
160:; author Peter Reid Kongstvedt notes in
1161:Forum for Health Economics & Policy
1050:Frontiers of Health Services Management
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96:that catalogue the billing items, as a
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1317:Health insurance in the United States
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979:University of Kentucky College of Law
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634:
620:. Opus Communications. pp. 2–4.
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369:Rosenthal, Elisabeth (June 2, 2013).
303:Health insurance in the United States
797:. Delmar Cengage Learning. pp.
485:
435:
388:
167:
134:Existing legislation and regulations
1043:"Price Transparency Begins at Home"
558:Rosenthal, Elisabeth (2017-03-29).
288:Explanation of benefits (insurance)
127:America's Health Care Crisis Solved
13:
1322:Health policy in the United States
1206:
210:University of California, Berkeley
124:and Dan Perrin note in their book
14:
1333:
1283:
741:Essentials of Managed Health Care
650:. Ester Republic Press. pp.
341:Rosenberg, Tina (July 31, 2013).
110:Essentials of Managed Health Care
1246:"Coming up with 'A Bitter Pill'"
1112:Anderson, Gerard F. (May 2007).
1066:10.1097/01974520-200701000-00004
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57:at several times that of actual
1312:Healthcare in the United States
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871:
739:Kongstvedt, Peter Reid (2012).
711:
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647:Mired in the Health Care Morass
531:Herman, Bob (October 3, 2012).
1250:"Stories I'd like to see" blog
551:
524:
283:Dartmouth Atlas of Health Care
68:
1:
1296:Medicare Provider Charge Data
1224:. Time Warner. Archived from
917:Herman, Bob (July 16, 2012).
855:Health Economics & Policy
592:"Hospital Price Transparency"
328:
149:, a regulation known as the "
853:Henderson, James W. (2008).
208:to help improve the system.
198:noted in a 2006 article for
7:
1041:Robinson, James C. (2007).
227:
217:help remedy the situation.
206:consumer-driven health care
10:
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1276:Columbia Journalism Review
878:Kongstvedt, Peter (2009).
683:(4). Project MUSE: 11–12.
162:Essentials of Managed Care
26:In the United States, the
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36:charge description master
1133:10.1377/hlthaff.26.3.780
923:Becker's Hospital Review
616:Abbey, Duane C. (2005).
537:Becker's Hospital Review
1016:10.1377/hlthaff.25.1.57
644:Davis, T. Neil (2008).
106:chief financial officer
1173:10.1515/fhep-2012-0007
677:Hastings Center Report
220:In a 2007 article for
151:Payers' Bill of Rights
21:Chargemaster (company)
1216:(February 20, 2013).
689:10.1353/hcr.2007.0061
405:(February 20, 2013).
192:Health care economist
1228:on February 26, 2013
971:Kentucky Law Journal
925:. ASC Communications
766:Health Care Policies
539:. ASC Communications
423:on February 26, 2013
293:Healthcare Blue Book
270:United States portal
188:Kentucky Law Journal
718:Kongstvedt, Peter.
511:State of California
442:Peden, Ann (2011).
1157:Chalkidou, Kalipso
1155:Anderson, Gerard;
828:. Wiley. pp.
564:The New York Times
375:The New York Times
348:The New York Times
298:Health care prices
86:medical procedures
1244:(March 5, 2013).
478:978-0-7637-5661-1
313:J. Patrick Rooney
168:Critical analysis
122:J. Patrick Rooney
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323:Underinsured
318:Medical debt
278:Charity care
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1167:(3): 1–22.
507:OSHPD – HID
417:Time Warner
114:Lewin Group
90:blood tests
69:Description
1306:Categories
1095:2013-03-05
955:2013-06-24
627:1578396301
577:2017-04-03
329:References
147:California
1264:March 25,
1197:154853606
1181:1558-9544
1060:: 25–28.
572:0362-4331
380:August 1,
354:August 1,
1232:March 7,
1189:31419860
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1082:14263360
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929:March 4,
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543:March 4,
516:March 4,
427:March 4,
228:See also
194:scholar
158:Maryland
120:Authors
75:hospital
44:hospital
830:137–139
705:9278168
78:patient
47:patient
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142:ways.
55:prices
1193:S2CID
1089:(PDF)
1078:S2CID
1056:(3).
1046:(PDF)
723:(PDF)
701:S2CID
652:54–55
59:costs
34:, or
1266:2013
1234:2013
1222:Time
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1177:ISSN
1138:PMID
1070:PMID
1021:PMID
931:2013
884:ISBN
859:ISBN
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770:ISBN
745:ISBN
693:PMID
656:ISBN
622:ISBN
603:2022
568:ISSN
545:2013
518:2013
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448:ISBN
429:2013
412:Time
382:2013
356:2013
175:Time
1169:doi
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145:In
40:CDM
1308::
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