What are US hospitals hiding? None of the 19 hospitals the WSJ surveyed could say what a patient with Medicare or a patient without insurance would have to pay for the knee-replacement surgery...their best guesses ranged from $33K to $101K...maybe.
Consumers and corporations are usually unable to get accurate information about how much medical treatment will cost them before they receive it, a new government study has found.
Investigators from the Government Accountability Office, a watchdog agency which works for Congress, tried to get upfront estimates from a variety of hospitals in Denver for the price of a full knee-replacement surgery.
None of the 19 hospitals surveyed could say what a patient with Medicare or a patient without insurance would have to pay for the knee-replacement surgery, the GAO reported. Of the 19 hospitals, two did not respond to inquiries, and 10 could not provide any price information at all. The rest offered broad ranges of potential charges, such as between $33,000 and $101,000, or an average charge, such as $82,000, based on the typical charge to an uninsured customer.
Many hospitals said they could not make a good calculation unless they had more information, such as billing codes, the length of time the patient would be in the operating room, the model of knee used or what kind of anesthetic would be provided.
“This lack of health care price transparency presents a serious challenge for consumers who are increasingly being asked to pay a greater share of their health care costs,” it said. (For more on that trend, check out the recent WSJ story on what to expect from open-enrollment season.)
For corporate directors of HR, this lack of transparency makes it not only difficult to compare the return on investment for a global healthcare travel program but also makes it quite a challenge to compute procedural savings for employee incentive programs.
Of course, employers know very well what the costs of providing healthcare benefits will be in 2012. This year, the average cost of an employer-provided family plan hit $15,073, according to a major employer survey by the Kaiser Family Foundation and the Health Research and Educational Trust. That was up 9% from 2010, and represents a 31% jump from five years ago, when coverage cost $11,480.
According to early results of a survey by Mercer, a consulting unit of Marsh & McLennan, about a third of employers are going to bump up the deductible, co-payments or annual out-of-pocket maximum. About 7% will boost some other type of cost-sharing.
So it should come as a welcome relief for corporations that some of the most expensive orthopedic, bariatric and cardiovascular procedures can be done for about 60% less in India or Costa Rica...with superior outcomes and patient satisfaction, when compared to the secretive procedures of US hospitals.
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