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Hospital prices are about to go public in the U.S.

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Re: Hospital prices are about to go public in the U.S.

#211

Post by epmaybe »

novalis78 wrote: post #171

For someone who worked on price transparency in 2013 - I was personally affected with surprise billing - and spent long hours working on a price discovery / transparency tool called pricepain.com, this (first step of an) anti cartel measure brings tears of joy. While it won’t solve all issues at once, shining some light into the medical billing mess can only be a good thing, allow market forces to enter the picture s…

Something I worry about, and that maybe you can help shed some light on, is what the ramifications of such a move would be.

You mentioned the grading of schools leading to higher quality. Do we know if any metric suffered as a result? One guess I have is that teachers started teaching for the test rather than for the foundation.

Take that same question and apply it back to the issue of hospital cost. If there's more transparency, the obvious conclusion is that there will be increased competition and an overall lowering of costs for patients. Does that come at the cost of quality of care? My gut says no, but my brain says that hospital administrators are incredibly talented at cutting costs. Maybe we have other safeguards such as HCAHPS to prevent the worsening of quality.

And as my own comment on this situation - how does this move fit into the insurance realm? My understanding is that hospitals will display the overinflated prices, but not the individual insurance negotiated prices. So how does this increased 'transparency' help?

Re: Hospital prices are about to go public in the U.S.

#212

Post by LeftTurnSignal »

arethuza wrote: post #117
QuantumGood wrote: post #110

Earlier quoted context omitted.

Had new insurance and a sore shoulder. Was billed ~$1,400 for a physical therapist to examine it ("evaluation"). No treatment. Very little covered by insurance. The next day had a chiropractor treat it and shoulder was fine. $25 with coupon. Funny part is, as it was new insurance, I spent over 30 minutes with insurance rep in advance on phone going over options and trying to get an idea of likely costs. When I had a…

So you have insurance but it doesn't cover stuff when you are actually ill? Does your insurance policy actually spell stuff out so that you can predict what will or won't be covered? Note: I'm from the UK and find the stories about US healthcare insurance grimly fascinating....

Welcome to the US.

I'm currently fighting insurance because they won't cover a GI tract test without "proof" from another test first.

OK that's understandable. You don't want random people asking for tests all the time, but the Dr already saw me, and gave me meds to fix the issue that would give the insurance company "proof." There's just new complications now.

So I get to wait until everything comes back in full force. Last time I couldn't work for a few weeks, but hey at least they're saving a few hundred at most now....

This is still a better experience than the issues I had with my jaw. The jaw issues are the only pain in my life that was bad enough I blacked out twice from it. But insurance won't cover that because they think it's a dental issue, dental won't cover it because it's the jaw.

The only treatment for the jaw I got was because a jaw specialist lied on the insurance papers. He said he wrote down headpains, not jaw issues. He said he learned that telling insurance companies the truth is not what gets them to cover their clients.

/sidenote that jaw pain is second to none. It runs circles around any migraines (the dark room, no sound kind) I've ever had. Never knew there was such pain before.

Re: Hospital prices are about to go public in the U.S.

#213

Post by mgr86 »

sturgill wrote: post #185
codingdave wrote: post #176

I'd be happier to see regulated business practices. While I agree that the prices are a problem, I've felt more pain from bills that keep coming in for more than a year after a major event. And when I go to complain, they say that someone made a mistake, the insurance took a long time to respond, or some other excuse. Give me a final bill with all charges within 30 days, then 30 more days to resolve any issues with t…

I currently use hospital billing as an example when explaining the halting problem. You’re never sure if you’ve paid off an incident or if another bill will show up in a few months...

Before we were married my wife had an MRI. Having not met her deductible they sent her a bill for 1.5k. Not ideal but we were able to afford it and paid the bill. 364 days later we received another bill for roughly the same. We thought there was an error. After months of back and forth, even after they had told us for 2months that “they took care of it and we would not be charged” we ended up having to pay another $500. This whole process was beyond infuriating.

The other bill apparently came from the Dr who read the MRI. The fun part was we were never contacted by that Dr about the results. She eventually left the hospital and she canceled our follow up appointment.

Re: Hospital prices are about to go public in the U.S.

#214

Post by cmiles74 »

bookofjoe wrote: post #172

Pro tip: I was a neurosurgical anesthesiologist at the University of Virginia Health Sciences Center for twelve years (1983-1995). Every now and then I'd get a call from our billing office that they'd received a letter from a patient I'd cared for who was too poor to pay what our department had billed (usually many thousands of dollars: I had NO IDEA what our charges were, BTW, nor did any of my colleagues in the dep…

This was my experience when my partner received treatment and the insurance company refused to cover the anesthesia charges (they claimed anesthesia was optional for the procedure and thus wasn't covered). The anesthesiologist's office was surprised that it wasn't covered and waived the charges.

It was the only bright spot in a prolonged battle with the insurance company and the hospital.

Re: Hospital prices are about to go public in the U.S.

#215

Post by itissid »

karmelapple wrote: post #195

I was in a hospital in Singapore recently, and the prices for doctor consultation fees, staying in a room, and even certain tests were listed right at the front of the emergency room desk. After the patient I was with was stabilized, the nurse confirmed with us verbally what the rough cost should be for the rest of what the doctor prescribed, and asked if we wished to proceed. We could have said no and gone elsewhere…

Playing the devil's advocate for a sec here. But If you paid out of pocket and later got reimbursed by the insurance company, I think, you would have to deal with the insurance company later. The system in the US is quite different and although broken it can be fixed by just fairer price comparison mandated by law.

Re: Hospital prices are about to go public in the U.S.

#216

Post by giancarlostoro »

bookofjoe wrote: post #172

Pro tip: I was a neurosurgical anesthesiologist at the University of Virginia Health Sciences Center for twelve years (1983-1995). Every now and then I'd get a call from our billing office that they'd received a letter from a patient I'd cared for who was too poor to pay what our department had billed (usually many thousands of dollars: I had NO IDEA what our charges were, BTW, nor did any of my colleagues in the dep…

Another big tip: if you need an X-Ray or any kind of exam done, don't do it in a hospital. Go to a clinic (if applicable of course) that specializes in those kind of exams and is covered by your insurance company if you can, it will cost a lot less usually. You can usually call your primary and ask them what clinics or labs they recommend. You'd be surprised what a huge difference that makes.

Re: Hospital prices are about to go public in the U.S.

#217

Post by GarrisonPrime »

codingdave wrote: post #176

I'd be happier to see regulated business practices. While I agree that the prices are a problem, I've felt more pain from bills that keep coming in for more than a year after a major event. And when I go to complain, they say that someone made a mistake, the insurance took a long time to respond, or some other excuse. Give me a final bill with all charges within 30 days, then 30 more days to resolve any issues with t…

It is regulations that have given us the current obtuse system.

When you give agency to someone so they can "fix the problem" you inevitably create a means for wealthy special interests to grasp control.

Re: Hospital prices are about to go public in the U.S.

#218

Post by phkahler »

One thing I advocate is fixed pricing. It's great to put prices online, but as long as insurance companies and such get to make deals there will be no real transparency or competition. The one downside I see to enforcing the prices is that it would ruin this ability to offer a break to people who need it.

On the other hand, with enforce posted prices those prices would come down to levels similar to what insurance companies pay so the sticker shock to those uninsured would be significantly lower. Still, there will always be those in need.

Re: Hospital prices are about to go public in the U.S.

#220

Post by maehwasu »

dakom wrote: post #40

How about transparency of medical records - i.e. if I provide some credentials, can I definitively get a copy of my medical history so that I can easily take it with me to another country/hospital? By definitively I mean within some federal regulation or system that doesn't depend on an employee at a particular hospital getting around to it on their coffee break.

Coral Health (in ios and play stores) lets you do this already for lots of hospitals.
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