Why is it that I don’t find the title of a recent NBC report surprising?
NBC Summary of Recent Study: “Some Hospitals Marking Up Treatments By as Much as 1000%”
Here is an excerpt:
Twenty of the hospitals in the top 50 when it comes to marking up charges are in Florida, the researchers write in the journal Health Affairs. And three-quarters of them are operated by two Tennessee-based for-profit hospital systems: Community Health Systems and Hospital Corporation of America…
Hospitals negotiate different rates with different payers.
Then there are in-network and out-of-network rates. And patients often don’t know until after they’ve received a treatment whether their insurance will pay for it, or for the doctors who delivered it…
States can and should regulate what hospitals charge. Maryland sets hospital rates but is the only state that does. West Virginia regulates rates, while only California and New Jersey have state legislation that requires for-profit hospitals to offer discounts to eligible uninsured patients.
My personal experience
Recently, a hospital on the northside charged my family in excess of $3000 for handling/processing an outpatient biopsy specimen (not pathologist interpretation) which was at least 10-fold what an independent pathology lab charged for the same service. When I received the bill, I was quite upset. The physician who sent out the specimen did not inform me that he intended to send the specimen to this hospital and seemed to have no idea about the costs.
I am certain that if I were given the choice of several pathology labs for processing that I would not have been convinced that there was added value in the specimen going to the hospital.
As a physician, when families ask me how much a procedure is going to cost, it is usually not an easy question and often requires a fair amount of research, particularly if the something involves a procedure at the hospital.
Take-home message: How is it that in this information era that medical costs are not transparent?
Unfortunately, you really do not know how good your medical coverage is until you find out through personal experience.
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