What will my hospital stay cost? Families deserve an answer in minutes
On 12 October, the Union health ministry asked every state to make hospitals display their prices. It is a welcome step, but not enough. A hospital's rate card can list 2,000 prices, and a family in a crisis cannot make head or tail of it—nor does a list tell them what their final bill will be.
As a clinician and former hospital chief executive, I have seen why. Hospitals treat a wide range of ailments with advanced technologies and a wide variety of medications, so a single bill can run into hundreds of line items. And all the labour, materials and equipment used must be captured and fed to the billing system in real time—without errors. Families expect (almost demand) a narrow estimate. But each patient is unique, and even for common procedures, complications can and do happen.
Many hospitals solve this with packages—a hernia surgery package, for example, covering the room, the surgery, the medicines and some specific tests. But a diabetic patient needs more tests, a patient with heart failure needs care from the cardiology team, and an unexpected complication (an allergy to a medicine, say) lengthens the stay. Off-the-shelf packages cannot capture every scenario, and families perceive any variation from the estimate as dishonesty.
Transparency is key
Transparency generates trust, but only transparency that a family can use. A family should be able to take a recommendation from a trusted doctor and get price quotes for exactly that treatment from 10 hospitals—within minutes, and all online. That needs two steps.
First, a treatment recommendation from their doctor in four standardized parts: the treatment (medical or surgical), the expected length of stay, any high-value implants or devices, and the patient's known conditions (diabetes or heart failure, for example). The hospital's software, not the doctor, would code the treatment in the Central Government Health Scheme (CGHS) code list of October 2025, which covers about 2,000 services—the vast majority of what tertiary care hospitals do.
CGHS would serve as a common language and a base coding system, not a price cap. The recommendation would belong to the patient in their digital health record.
Second, each hospital publishes its own price in rupees for each of these codes (by room category where it applies), in a format that apps can read, and keeps it current. How a hospital sets those prices remains its own business. A family will rarely read this list. Their app will.
Medicines and consumables are harder. Hospitals bill them at the printed maximum retail price (MRP), and the amounts they pay their suppliers are commercially confidential. Rather than reveal their margins, hospitals should publish what their prices exclude, the MRP of high-value implants and devices, and an indicative range of what medicines and consumables have typically added to the bill for each code. A planned hernia repair can be estimated closely. A patient admitted with heart failure can only be given a range because no doctor can predict on day one how long that patient will need intensive care.
The same two steps work for insured patients. The rates hospitals negotiate with insurers are confidential and need not be published. An insured family can upload its coded recommendation into the insurer's app. And the insurer, which already holds those rates, can show its policyholder the likely co-payment, room-rent eligibility and use of the sum insured at each network hospital—without revealing the rates to anyone else.
With these inputs, third-party apps and insurers can turn a treatment recommendation into a rupee estimate for every hospital, and a new ecosystem will grow around what doctors and hospitals publish. If a doctor at a second hospital changes the plan, that hospital must explain the reason in writing before admission.
It is a win-win. Hospitals retain the freedom to set their own prices, and families (cash or insured) receive comparable estimates within minutes, which they can use to make an informed decision about which hospital to select. Other factors, such as the quality of care, the doctors, customer friendliness and additional facilities, will help hospitals differentiate themselves beyond pricing.
The 12 October letter was a good first step. The next step is for the government to enforce meaningful price transparency and support an independent information ecosystem to help families make informed decisions, without regulating prices.
Dr Ajay Bakshi is a neurosurgeon and former chief executive of three Indian hospital chains: Max Healthcare, Manipal Hospitals and Gleneagles Hospitals.