There is a moment, late at night, when the hospital is quietest. Not silent. A hospital is never silent. There is the beeping and the footsteps and the soft pneumatic sigh of a door closing on the ICU ward. But the administrative floors are dark. The compliance department is dark. The revenue cycle office is dark. The spreadsheets are still running on servers in a windowless room on the second sublevel, but no one is watching them. The spreadsheets do not need to be watched. They do what spreadsheets do.

I go home. I have a home in a neighborhood where the ambulances do not come often. I have a personal laptop. Sometimes, late, I open it. Not for work. For something else.

The CMS price transparency portal is public. Anyone can search it. I searched it once. I typed in my own hospital. I typed in a procedure I had last year — a routine thing, nothing serious, the kind of thing a man my age gets checked. I found the chargemaster price. I found the negotiated price my executive plan paid. I found the cash-pay price.

The cash-pay price was eleven times what my plan paid. For the same room. The same machine. The same technician who called me “sir” because she had seen my badge and knew my title.

I closed the laptop. I did not search again.

Source: The Price Is Correct

Related: The Claim Was Processed (Before I explain what my department does, I need to explain why it exists…)