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Hospitals lift curtain on prices, revealing giant swings in pricing by procedure

healthcaredive.com

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Re: Hospitals lift curtain on prices, revealing giant swings in pricing by procedure

#11

Post by SamuelAdams »

scheme271 wrote: post #5

This will probably help a bit but in an emergency people don't have the time to compare prices. And with US health care, it just takes one accident that sends you to the ER and where someone that's out of network performed a procedure to end up with a bill that's tens or hundreds of thousands of dollars.

Yes but emergencies are the exception, not the norm for most hospitals. Most hospitals make 40-60% of their revenue on elective surgeries, ie things that can wait 2-6 months. So patients have time to shop around.

Source: currently work at a big hospital in IT.

Re: Hospitals lift curtain on prices, revealing giant swings in pricing by procedure

#12

Post by 1123581321 »

scheme271 wrote: post #5

This will probably help a bit but in an emergency people don't have the time to compare prices. And with US health care, it just takes one accident that sends you to the ER and where someone that's out of network performed a procedure to end up with a bill that's tens or hundreds of thousands of dollars.

That is old information. In the US, your deductible and copay have to be the in-network price in emergencies, and balance bills from the provider will not be allowed in emergencies starting next year (and you can already usually get the balance waived with sliding scale charity etc.)

Re: Hospitals lift curtain on prices, revealing giant swings in pricing by procedure

#13

Post by maxerickson »

scheme271 wrote: post #5

This will probably help a bit but in an emergency people don't have the time to compare prices. And with US health care, it just takes one accident that sends you to the ER and where someone that's out of network performed a procedure to end up with a bill that's tens or hundreds of thousands of dollars.

You don't pay up front in an emergency, so people can consult the information and ask questions before they do pay. They can call their insurance company and ask why they pay more than average. And so on.

Re: Hospitals lift curtain on prices, revealing giant swings in pricing by procedure

#14

Post by toomuchtodo »

Someone1234 wrote: post #10

Local hospital released this as an Excel spreadsheet (Chargemaster). They have a column called "Uninsured cash price." These prices are And, no, I don't think this was by accident as they have updated this Excel spreadsheet several times and only that one column is always set to 0 size.

File a complaint with Health and Human Services [1]. It is clear they are not acting in good faith. Take snapshots of the URL with the Internet Archive for notarization [2].

[1] https://www.cms.gov/hospital-price-transparency/contact-us

[2] https://web.archive.org/save

Re: Hospitals lift curtain on prices, revealing giant swings in pricing by procedure

#15

Post by nradov »

scheme271 wrote: post #5

This will probably help a bit but in an emergency people don't have the time to compare prices. And with US health care, it just takes one accident that sends you to the ER and where someone that's out of network performed a procedure to end up with a bill that's tens or hundreds of thousands of dollars.

A recent federal regulation which implements the No Surprises Act of 2021 should reduce some of those abuses by hospitals.

https://www.cms.gov/newsroom/press-releases/hhs-announces-ru...

Re: Hospitals lift curtain on prices, revealing giant swings in pricing by procedure

#16

Post by topspin »

dpayonk wrote: post #3

There is obviously a ways to go to create a system where price transparency is feasible, but I’m very interested in how the community might think it would affect the value based healthcare industry with respect to total cost of care management and bundled services? You cannot always look at a service in isolation because of complications on episodes like joint replacements or the impact of chronic conditions over the…

"You cannot always look at a service in isolation because..."

The medical industry is adept at excuse making and impeding change. If we wrap ourselves around every conceivable axle then nothing will be achieved. As it is providers and payers already employ elaborate coding systems to represent work and ascribe costs. Step one is to kick open that door and make this transparent. Should the result prove inadequate to sufficiently represent every imaginable nuance then the medical industry can engage in the necessary rework under that pressure.

Re: Hospitals lift curtain on prices, revealing giant swings in pricing by procedure

#17

Post by peterangular »

scheme271 wrote: post #5

This will probably help a bit but in an emergency people don't have the time to compare prices. And with US health care, it just takes one accident that sends you to the ER and where someone that's out of network performed a procedure to end up with a bill that's tens or hundreds of thousands of dollars.

The other big conflict here is that I'm not an expert and I'm not about to turn down services if recommended to me by an expert in a field which I have no experience.

I get the whole "do your research", but often it's in areas in-which I have no real capability - especially with healthcare.

---

> And with US health care, it just takes one accident that sends you to the ER and where someone that's out of network performed a procedure to end up with a bill that's tens or hundreds of thousands of dollars.

Agree. And to add, all it takes is one procedure that your insurance company doesn't want to cover to put you into literal billing hell for months on end. My point being, even with price transparency they can just chose not to pay even if they're obligated (and they do this). If there's any way they can weasel out of paying they will.

I'm still 100% in support of price transparency in healthcare however... there's just so much broken with it and I've lived through the hell.

Re: Hospitals lift curtain on prices, revealing giant swings in pricing by procedure

#18

Post by [deleted] »

maxerickson wrote: post #13
scheme271 wrote: post #5

This will probably help a bit but in an emergency people don't have the time to compare prices. And with US health care, it just takes one accident that sends you to the ER and where someone that's out of network performed a procedure to end up with a bill that's tens or hundreds of thousands of dollars.

You don't pay up front in an emergency, so people can consult the information and ask questions before they do pay. They can call their insurance company and ask why they pay more than average. And so on.

[deleted]

Re: Hospitals lift curtain on prices, revealing giant swings in pricing by procedure

#19

Post by arcticbull »

hanniabu wrote: post #8
scheme271 wrote: post #5

This will probably help a bit but in an emergency people don't have the time to compare prices. And with US health care, it just takes one accident that sends you to the ER and where someone that's out of network performed a procedure to end up with a bill that's tens or hundreds of thousands of dollars.

The whole out of network aspect in hospitals is ridiculous

Yes, in a single-payer environment everyone is in-network.

Every doctor in Canada providing covered medical services is in-network.

Re: Hospitals lift curtain on prices, revealing giant swings in pricing by procedure

#20

Post by Someone1234 »

toomuchtodo wrote: post #14
Someone1234 wrote: post #10

Local hospital released this as an Excel spreadsheet (Chargemaster). They have a column called "Uninsured cash price." These prices are And, no, I don't think this was by accident as they have updated this Excel spreadsheet several times and only that one column is always set to 0 size.

File a complaint with Health and Human Services [1]. It is clear they are not acting in good faith. Take snapshots of the URL with the Internet Archive for notarization [2]. [1] https://www.cms.gov/hospital-price-transparency/contact-us [2] https://web.archive.org/save

I actually might, the wording on this page:

https://www.cms.gov/hospital-price-transparency

Does say "provide clear, accessible pricing information" which I would argue this is not.

edit: Filed a complaint.

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