Several Arkansas hospitals now have “price transparency” pages on their websites to comply with a new federal law that went into effect Tuesday requiring hospitals to post the prices of services online in a machine-readable format.

Mercy Hospital Fort Smith, Mercy Hospital Northwest Arkansas, Baptist Health, Washington Regional Medical Center and the University of Arkansas for Medical Sciences are among some of the largest medical centers in the region with their prices available.

“It’s a step in the right direction to increase transparency,” said UAMS Chief Financial Officer Amanda George. “It’ll be good for patients to know what to expect going in. It’s a way to help them prepare in advance, because some people are surprised when they get a bill in the mail, so we’re trying to prevent that on the front end.”

The Affordable Care Act already requires hospitals to release price information, but the new rule mandates this be put online and updated yearly. It is encouraged, however, that updates be made as appropriate, even if it is within one year.

George said UAMS began preparing for this since the Centers for Medicare & Medicaid Services announced the change.

The rule not only applies to traditional hospitals but to rehabilitation centers, critical access hospitals and psychiatric hospitals.

There may be several differences, however, in what patients see and what the actual out-of-pocket price will be.

First, hospitals are required to provide an itemized list of services but not necessarily an average cost of treatment. A surgical procedure may be listed at one price and not include the recovery room, supplies or pharmacy charges. Those would need to added to the price of the procedure.

Second, the charts don’t include physician charges. This is a separate cost for the patient.

Some hospitals, such as the Mercy Healthcare System, are providing diagnostic related grouping (DNG) charts. This is how Medicare and various insurance companies categorize costs and determine what they will pay toward the patient’s care. If a person’s diagnosis or treatment is a certain category — vaginal delivery versus cesarean section, healthy newborn versus full-term neonatal services — insurance or Medicare will pay a fixed amount based on the DNG.

DNG charts can be complicated, too, though. Many of the treatment categories are broken up further, with prices differing if there is a complication or major complication. For example, the average charge for a vaginal delivery without complicating diagnoses is $11,346. If a woman has a vaginal delivery without complications and without sterilization, the charge is roughly $10,299. If there are complicating diagnoses, delivery is an average of $13,528.

“Standard prices are provided for the 50 highest volume inpatient services as well as high-volume outpatient tests and treatments,” Mercy spokesperson Todd Nighswonger wrote in a statement. “Charges billed are based on actual care provided and will vary from patient to patient, depending upon differences in treatment plans, complications, services ordered by physicians and the individual patient’s health. Professional charges are billed separately by individual physicians for services such as radiology, surgery, anesthesia and laboratory.”

Another aspect to the rule is that it doesn’t show patients what their insurance or Medicare will pay, which could create sticker shock for some.

Nighswonger said Mercy, however, can provide a personalized out-of-pocket charge estimate when patients schedule or register.

When evaluating price information for various hospitals, particularly DNG charges, it is unclear what causes the differences. For example, Mercy Fort Smith charges an average of $58,529 for a respiratory system diagnosis with ventilator support for less than or equal to 96 hours. The same grouping at Washington Regional is listed at $73,628.

These price differences are also seen within the same hospital system. At Mercy Northwest Arkansas, the same treatment is listed at $80,389. Outpatient services are the same. A comprehensive metabolic panel at Mercy Fort Smith is listed at $175 but $269 at Mercy NWA.

It should be noted some services at Mercy NWA are listed at lower charges than Mercy Fort Smith. Nighswonger was unable to provide an answer as to why this occurs but is looking into it for the Times Record.

Baptist Health, which recently purchased Sparks Health System, did not comment on the new ruling. The Times Record was redirected to the Arkansas Hospitals Association, which did not return a request for comment by 5:30 p.m. Friday. Baptist does have itemized price lists available on its website.

Fort Smith is home to the Arkansas Colleges of Health Education with its College of Osteopathic Medicine already open. Susan Devero, director of community relations, said none of the doctors could comment on the new ruling as they are all associated with a hospital.

Despite some of the confusion and hundred-page documents, George said she believes this rule will be good long term.

“(Patients) need to be prepared for what their bill will look like and what all goes into it,” George said.