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 ...
Not even at check out, but a month later.
Lol, that was my question also. Quite a bit of effort defending a known extremely crooked system.
Well it will stop idiots from getting their kids ears pierced at $2k VS the maybe $50 at a jeweler.
I’ll be up early on Black Friday looking for the best price on a colonoscopy
Depending on where you live most Refraction’s by a Optometrist are about $65. Don’t use your Ophthalmologist as Refraction’s is not their specialty an you will pay more. I read our statements from Medicare/Tricare Life.
My blood work depends on what they are testing for. Diabetic test equipment is WAY over charged.
Canadian docs can refuse to treat you. Hubby’s aunt had a Heart Doc and Primary, She fell broke her back, PCP told her to go home and DIE she was so old and would not treat her. Her Heart doc did. Took her a year to heal, lived another 5 good years.
bookmark
I would love to hear you give an example how an MRI of the knee could go off in any direction other than the same. This is also true for many tests like an ekg, blood work, the price of a room, etc., etc., etc. I think that our President is on to something here.
I was in York Hospital (PA) for 23 days in 2017, and it cost $887,500 and then in PSU-Hershey Hospital for 11 days, for severe-acute Pancreatitis, and it cost $210,850 which Geisinger Gold and Medicare paid all of, except my $6.500 deductible. A LOT of charges above and beyond those costs, were “denied” by both Geisinger and Medicare.
Early in my career I worked in medical research and our unit did chemical analysis on patient blood samples
The machine would perform multiple tests simultaneously at no added cists as part of the analysis and output the results from the full suite of tests automatically.
We actually had to perform extra work to suppress the reporting of the tests not specifically ordered a given physician for a given patient on a given day.
Rather than simply sending the entire suite of test results to the doc which would have given him the best information about the physical condition of the patient, we had to suppress any thing not on the write up.
Worse, the hospital charged for each individual test parameter, despite the fact that they were done automatically at the same time on the same instrument and all for one cost.
If the doc specifically ordered one of the tests whose results we normally manually suppressed from the report, the patient was charged up to a thousand dollars EACH for reporting and not suppressing each of the additional test results requested.
Patients died, did not fully recover, had longer hospital stays and experienced less successful and satisfactory outcomes because nobody could afford to pay the piecemeal prices for the results of the of the full suite of test despite the fact that the results were all generated automatically at the same time for one cost and it actually cost labor time and money to suppress the results when the full suite could have been provided faster and cheaper while proving vastly improved patient care with better outcomes.
Call me a bad, disloyal employee but I was press ganged into working the night shift alone as a student supporting intensive and critical care units due to staffing shortages and I ran my own show.
I made sure the docs and interns were aware of the situation and I was always overworked and under time pressure. Lets just say I was usually legitimately far to over worked and busy to spend the time suppressing the the test results and when not busy I became amazingly inept at suppressing the test results.
Patient outcomes improved due to better diagnostics and mortality and complication rates dropped, so much so that the medical staff began demanding the other shifts follow suit and begin handing out the full reports.
Now that the cat was out of the bag the situation came to the attention of administration
Much hilarity ensued as I became embroiled in the most enjoyable dispute in my entire career.
Went to work that night and met at the door by administration and security. Administrator informed me I was terminated on spot and would be escorted from building by security. Also was told they were petitioning for my expulsion from the university.
Unfortunately, the genius admin staff was unaware I was covering the shift alone and had failed to line up a replacement, which there wasn't. Security did not even get me as far as my car before admin was calling him asking him to bring me back.
By the time I hot back the admin suits were surrounded by angry and loudly complaining docs and they sheepishly had to beg me to come back and cover the shift - and then be put on administrative leave pending investigation to be fired. If I did, they would not pursue expulsion. Which I accepted
My suspension lasted about one glorious and peaceful week where I got my first full nights sleep in almost two year, became fully caught up on homework and actually had time to hit a few bars and go out on a date
The medical staff was agitating for my return and admin was discovering that my job function was an emerging specialist discipline self taught by by staff with very few qualified replacements and none that they could hire, much less capable to work the night shift solo.
Was really enjoying freedom to be a normal student . They tried to recall me to work - all dins forgiven Didn't want to go back and refused to even meet with admin pukes but the docs convinced me to come back to work - at professional pay rates instead of student wages which amounted to a $30 per hour pay raise - with benefits (both if which which I should have been getting before)
After a few months, admin realized that not only were the improved diagnostics really improving patient care, the revenues from the testing were , paradoxically, increasing exponentially.
Turned out the cost - benefit for the individual test results caused the docs to ration testing to minimize costs and nobody could afford to order multiple results at piecemeal billing rates.
However, publishing the entire suite of results at price of what was previously the cost of one result was so compelling from a cost - benefit that docs could easily justify frequent testing as SOP. Revenues skyrocketed and they invested in several more if the expensive analytic systems to meet demand while further reducing price per test due to improved economy of scale
There are some lessons there. Some I learned from, some i’ll probably never learn.
One take away is that reducing costs and improving and expanding service to provide best quality care at lowest possible price beats trying to soak customers for money using high prices and rationing of services and care when it comes to revenue growth and profitability
Interesting times for kid just turned 21.
Doesn’t every hospital use the same “codes” for procedures/tests?
I admit I know little about how hospitals bill in practice, but my -ahem- assumption was that for a given list of codes, (whatever they are for) a hospital would have to list a price - and those prices could be compared with the same codes from other hospitals.
This, to me, could be a high-level measure of cost efficiency of a hospital - an inefficient hospital with lots of overhead would have a noticeably higher cost across the codes it delivers, while a cost efficient hospital would have a noticeably lower cost across the codes it delivers.
So I ask you since you are obviously knowledgeable in this stuff.... Would a consumer - even an unsophisticated consumer might be able to tell when comparing one hospital to another which one is more cost effective - in general by examining which one is most/least expensive across the broad array of codes?.
I can tell you that there is a system of codes that is approved year to year by the government, doctors and insurance companies. In fact, billings are done by “Certified Coders” who try to keep things standardized. Do Physicians and clerks follow the coding standards accurately? NO. Hence a lot of billing and coverage issues.
I recently had a recovery room charge turned down by Medicare. I was under a general and I went to the recovery room after serious Laparoscopic abdominal surgery — why was it turned down? Wrong code perhaps? I don’t know.
Hospitals and doctors in part leave their prices articifial as they bargin with each grouyp of insurers independently. The government gets the best of any — they pay the least.
I was in ICU for a month and then in a nursing home for another month.
Bill was over $3000,000. My out of pocket was $1200.00. Medicare payed the rest.
What else can I say?
FMCDH(BITS)
I can’t believe the nay-saying on this. It isn’t a panacea and it’s not going to fix all the issues with our healthcare system, but it’s a start. Granted, it won’t change much in emergency situations, but for routine care where consumers are self-pay or have a high deductible, it will make a difference. It will also enable hospitals to see what others are charging, and those market pressures should cause prices to drop somewhat.
With an uncooperative deep state, congress and media pushing hard against anything positive that Trump tries to do, he’s still doing what he can. Freepers should support that.
The problem with hospitals posting prices is they have no idea what anything they do costs.
The "settlement price" turned out to be $450.
Health care is a racket. There is a lot that will still need fixing even with "full price disclosure".
Quite a story!
Spoken like a true gored ox.
Medicine is now little more than big business and revenue goals and profits take precedence over patient care.
My take away was that reducing costs, increasing access and improving care to effect better patient outcomes was a much better business model than jacking up prices to maximum the market will bear and then rationing care levels and access to services.
From both a patient outcomes and revenues/ profits perspective.
Unfortunately ,our medical system seems to be going in opposite direction
The wild card here is technology and innovation.
The reason for the insane price scheduled for testing was because a few years back old tech required each test be performed individually and on separate pieces of equipment
The new technology allowed all tests in one shot on one machine but the admin suits were more concerned with maintaining their price than improving patient care and they only looked at a static analysis of the market and totally missed the opportunity from both a quality of care and revenue generation perspective of leveraging a big technological advance into better care driving greater revenue
Obama care is the ultimate example of driving costs astronomically into the far right corner and then rationing care to limit spending
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