Posted on May 24, 2008 | Category: Uncategorized
By Jan Greene
One of the many frustrating things about paying for healthcare these days is finding out how much you should be paying for a hospital-based service. It's completely hit-or-miss if you call a hospital's billing department and ask how much they would charge, list price, for a given procedure…maybe an elective surgery or imaging study like an MRI. You know why they can't tell you? There are a couple of reasons:
–They don't want to. Care is complicated and it's hard to predict exactly how much anesthesia or bandages or time your care might require. Giving you an inaccurate number could cause confusion later.
–They don't actually know. The healthcare "marketplace" has been screwy for so long that many hospitals don't actually know how much it costs them to provide a service and, therefore, how much they should charge an individual paying out of pocket. The vast majority of patients pay via Medicare or private insurance, which have either set rates or negotiated rates with each hospital. New high-deductible plans and HSAs that require more out-of-pocket paying are a new phenomenon, and hospitals haven't caught up.
There are a few sources emerging online that can give you hints of how much you can expect a hospital service to cost, and a few pioneering hospitals are out there offering the information for a list of major procedures.(This trend is known in health policy circles as transparency.) I'll start listing these in the resources section as I find them.
Here's one that's interesting:
www.ahd.com
This site's developer has pulled together all the hospital finance information that is publicly available through the federal government's Medicare system. Mostly the site owner sells the information to industry types, but also offers individual hospital profiles for free to anybody. So, for instance, I can find out that my local hospital charged the Medicare system on average $359 for an electrocardiogram (EKG). This is only a starting place for negotiations since Medicare pays less than private insurance rates, but at least you get a sense for what something could cost.
I'll look for some more and post them here in coming days.
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