Posted on 11/16/2019 8:57:40 AM PST by Hojczyk
On my Sunday TV program Full Measure, I’ve done quite a bit of reporting on the capricious cost of medical services at hospitals and how hard it is to get pricing upfront.
President Trump just instituted a new rule requiring hospitals to make that information available.
This could be a game changer.
As I reported the prices hospitals charge vary widely and often do not seem to correlate to anything in particular. Insurance and private payers may be radically overcharged.
From my story comparing prices:
One hospital in the Los Angeles area charged $400 for the knee MRI. But a hospital in smaller Des Moines, Iowa quoted $3,500 ($3,536). That’s eight and a half times as much for the exact same procedure.
Similar dramatic ranges are found within the same region. In Orlando, one hospital charged as little as $877 total. Another charged close to $2,000 ($1,980) and didn’t even include the fee to read the MRI.
Hospitals in Los Angeles charged from $400 to $2,800 ($2,850).
Raleigh-Durham: about a $1,000 ($1,023) to $2,700 ($2,775).
Des Moines also from about $1,000 ($1,071) to $3,500 ($3,536).
Dallas and Fort Worth: $500 ($508) to $4,200 ($4,274).
And the biggest disparity was in the New York City area. The cheapest knee MRI was about $440. Another hospital in the area the most expensive in the survey charged $4,500!
Under President Trump’s new rules, patients will be able to get this information upfront.
According to CNBC, “Hospitals will now be required to post their standard charges for services, which include gross charges, the negotiated rates with insurers and the discounted price a hospital is willing to accept from a patient.”
(Excerpt) Read more at sharylattkisson.com ...
Sir, you have kidney stones. We need to do a Cat Scan to confirm it.
How much is a Cat Scan?
I don’t know, but we have to do the test.
Why? You just told me what I have.
Because we do.
OK, the Cat Scan confirmed the stones, here are some drugs to make you comfortable until they pass.
Yes, that was an actual conversation. The only treatment was a bottle of pills (yes, opiods that worked wonders when used properly)
Good post.
Going in the other direction, look at what happened when the governments of Zimbabwe and Venezuela damaged the supply sides of their economies. Prices skyrocketed.
There’s worse. Like paying for gasoline and not knowing really how much it actually costs vs how much is tax! If the pumps actually showed the actual cost before tax, DC would be overthrown within a week.
I definitely get that you cannot tell a patient up front everything they are going to need in the course of care. But the idea that because of this transparency is useless is an idiotic notion. More information is always better.
No, but if the exact same procedure is $4500 at one hospital and $400 at a clinic across town, darn right I’m going across town. Enough of those, the hospital is dropping their rates to $500
I was in an accident.
I was in the hospital for 20 hours.
I had 2 sets of MRS
My bill is $58 thousand dollars
“Medical procedures are not exact science… and can and more often than mot...go off into several different directions.”
Every test and/or procedure has a “code” that is used in part to determine how much it costs.
If hospitals published that, we would know which hospitals are run most efficiently.
That along with published outcome data will drive hospitals to be run better.
Now if they address how services are delivered and by whom you would dramatically improve choices and costs for care.
If your case is complex, you pay more. If tests are ordered you can decide if you are willing to pay based on what it costs.
No downside from the patients perspective.
Because of O'Dummy more and more local providers refuse to take anything but cash or premium insurance. More and more providers are even refusing medicare.
If only the creeps in politics, all levels, were forced to go through the same hoops as everyone else. Even Ginsberg would be dead by now if she didn't get federal health care reserved for the elite.
Back to back “yuge” threads. “yuge” is the new “boom” and “bombshell”.
You’ve got to love leftists touting gubmit care.
With capitalist economy, if one hates GM/Ford/Chrysler, they’ve got choices from Europe, Japan, and Korea.
With a socialist/commie economy, you get a Yugo or a Trabant.
I only wish we could force socialists to ONLY have products from inferior socialist countries. That’s right - INFERIOR.
I’d like to hear the hospitals’ reasoning behind their pricing.
Do hospitals produce publicly available reports showing where their money comes from and where it goes?
Thank you President Trump.
After I was revived, I remembered I was insured.
Based on these example price differentials, medical tourism starts making a lot of sense.
This will force the prices to equalize around the country or people will just hop on a plane and save thousands of dollars.
Exactly what we need, more competition.
In most cases it does not matter what a physician or hospital designates as their standard price for a coded item. The insurance plan, the medicare agency, the medicaid agency, the supplemental plan insurance or others all tell the hospital what they will pay for the diagnosis related. With Medicare, for example it is a gross allowable that usually about 30% average of the listed charge less 20%.
If your hospital and related service providers charge 115,000 the agencies may wipe out 15k as not allowed and then authorize the 100k as being allowed at 30k gross. Medicare pays 80% of the 30k (24K) and your supplemental insurance pays the other 6k.
If a different hospital charges gross 85k for the same services, the agency still looks over all the detail to the paper work and cuts as they see fit but pay subsequently the same amounts for the coded procedure or service.
The consumer will be unable to use these changes to negotiate cash cafeteria care without a very detailed understanding of the codes and rules for allowable.
So many factors determine ‘out of pocket’ costs.
But shop around...and ‘forewarned is forearmed’ might be a byword of the day.
best to you.
Exactly, LauraJean.
“Can you imagine going into Walmart and NOT knowing what something costs until you’ve already checked out??”
...checked out, gone home, consumed the item and then get the bill
I tend to believe in the market over blindly paying for stuff.
My son has a chronic illness and when he was undergoing treatment we found thousands and thousands of dollars of “mistakes” Amazingly not one was a mistake in our favor.
One of the best was an $800 charge for an appointment I supposedly had with a pediatric gastroenterologist.
This bonehead charged me for a two minute conversation we had in an elevator when my son’s doctor introduced us.
Darn right I want to know up front what stuff will cost, when possible. Obviously trauma care is different, but in 56 years, I’ve never had to deal with major trauma care.
For full disclosure, are you a medical professional or an insurance person?
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