Even then, they say Medicare rates are a more relevant starting point. But this is where market dominance is so important. If you have the network insurers must have in a local area, you have a lot more firepower in negotiations, which allows you to get more "real" reimbursement than your less connected neighbor hospital. All of that is just noise to most patients.
With the release of this data, however, chargemaster pricing insanity is right there in black and white, which makes it relevant, at least in the game of perception. How should you react if, say, you are among the highest-charging hospitals in your local area? In your region? You probably don't want that label.
After all, it's as easy as the click of the mouse for patients and employers to see what you're charging and what Medicare is paying you. Besides that, local media is likely calling right now for an explanation, and they're as clueless about all of this as your patients probably are. All they see is the crazy variation.
So it's at least a public relations problem. But treating chargemaster variation as a public relations problem is what has gotten hospitals collectively into this mess.
Using the New York Times's wonderful map application to look at various hospitals is almost too easy. I spent the better part of an hour just clicking around to see the differences in local areas. Just click and compare prices. It's that easy—and it's fun—of a sort. I spent a good amount of that time looking at pricing in Nashville, where I live.