Study: Hospitals Often Unprepared To Quote Costs
|LINDSEY TANNER; LINDSEY TANNER The Associated Press|
Routine hip replacement surgery on a healthy patient without insurance may cost as little as
That's what researchers found after calling hospitals in every state, 122 in all, asking what a healthy 62-year-old woman would have to pay to get an artificial hip. Hospitals were told the made- up patient was the caller's grandmother, had no insurance but could afford to pay out of pocket - that's why knowing the cost information ahead of time was so important.
About 15 percent of hospitals did not provide any price estimate, even after a researcher called back as many as five times.
The researchers were able to obtain a complete price estimate including physician fees from close to half the hospitals. But in most cases, that took contacting the hospital and doctor separately.
"Our calls to hospitals were often greeted by uncertainty and confusion," the researchers wrote. "We were frequently transferred between departments asked to leave messages that were rarely returned, and told that prices could not be estimated without an office visit."
Many hospitals "are just completely unprepared" for cost questions, said
Most hospitals aren't intentionally hiding costs. They're just not used to patients asking. That's particularly true for patients with health insurance who "don't bother to ask because they know insurance will cover it," said co-author Dr.
But he said that's likely to change as employers increasingly force workers to share more health care costs by paying higher co- payments and deductibles, making patients more motivated to ask about costs.
The study was published online Monday in JAMA Internal Medicine.
Commenting on the study,
She said states and local hospital associations are the best source for pricing data, and that many states already require or encourage hospitals to report pricing information and make that data available to the public.
U.S. insurance companies typically negotiate to pay less than the billing price. Insured patients' health plans determine what they pay, while uninsured patients may end up paying the full amount.
The study authors noted that
Toohey, 54, said his health insurance covered most of the costs, and it didn't occur to him to ask about price beforehand. He was back at work two weeks later and is pain free. That's what matters most to him.
"I never really looked or paid attention" to the cost, he said.
He paid about
The average charge for hip replacement surgery at Loyola is about
Kudia said some patients do ask in advance about costs of surgery and other medical procedures, and those questions require "a little bit of research" to come up with an average estimate. Costs vary from center to center because "there is no standard pricing among hospitals across the country. Each hospital develops its own pricing depending on its market," he said.
An editorial accompanying the hip replacement study said "there is no justification" for the huge cost variation the researchers found.
A few online sites provide price comparisons for common medical procedures, but the editorial said that kind of information "is of almost no value" without information on hospital quality.
A proposed federal measure that would have required states to force hospitals to make their charges public failed to advance in
"It is time we stopped forcing people to buy health care services blindfolded," the editorial said.
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