It may sound strange but many hospitals won't tell you in advance the charges for a procedure, and they may add extra services at their whim which obviously you pay for and to top it all if you develop some complications or infection due to their oversight, you will be left holding the bill.
According to a study published in the Journal of The American Medical Association in February, a researcher gathered prices and information from 122 hospitals around the country as her healthy 62 year old grandmother needed a hip replacement.
Advertisement!9 hospitals could not give her any price information, and 27 hospitals gave her either the physician's price or the hospital price but not a combined price. From 57 hospitals she was able to get both the prices but only after calling separately for each. 19 hospitals gave her the combined information.
There was a huge difference in the combined costs - this made her research worthwhile. There was a tenfold difference, from $11,100 to $125,798 and the difference was among the top ten hospitals. Many studies have found that this price difference is found not just in major surgeries, but also for tests like an MRI can cost anywhere from several hundred dollars to several thousand. For the uninsured this can be a huge financial burden, and even those insured under high-deductible health plans will pay 100% for many tests and outpatient procedures.
Moreover, with the ongoing battle between UPMC and Highmark, Pittsburgher's will have to pay more if the doctor or hospital of their choice is "Out of network" in their health insurance plan.
Citizens, business leaders and public officials should demand best quality health care at affordable prices.
Hospitals should put up procedure rates on their websites, which should include all costs - physician services and facility charges. For a simple procedure like a colonoscopy, the charges can vary due to the type of anesthesia used and where the procedure is done.
Hospitals should provide detailed statistics on their quality of care. Regrettably the quality of hospital care in the Pittsburgh region has dropped and most hospitals in Pittsburgh are going to be financially penalized for poor quality care or high % of readmissions by Medicare.
Hospitals should offer a warranty for preventable complications. Geisinger Health System in Central Pennsylvania offers a warranty on services like a heart bypass surgery to maternity care. If you have a related problem or complication related to your original procedure, Geisinger does not charge anything and according to studies they deliver even higher quality care than earlier. Their cost has come down due to lesser complications and fewer readmissions. None of the hospitals in Pittsburgh offers any such warranty.
There should be a consumer friendly cost comparison website. There are some websites in Wisconsin and New Hampshire, though nothing in Pittsburgh till date. The governor and General Assembly need to provide the funding and the mandate to the Care Cost Containment Council to publish time and detailed reports on information regarding the prices and the quality of health care in the state.
Hannah Punitha (IRDA Licence Number: 2710062)
Harold D. Miller, 3rd March 2013
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