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Old 05-05-2016, 11:21 PM
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Default Healthcare "Transparency"

Interesting video from Vox

Giving birth costs a lot. Hospitals won't tell you how much.


Very difficult to get any information about pricing - even if you invest a lot of time in trying to find it.

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Old 05-05-2016, 11:28 PM
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Thanks for the news flash.
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Old 05-06-2016, 09:16 AM
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Thanks for the news flash.


I thought it was a "known issue" in healthcare that trying to find prices is a fruitless endeavor.

I have tried to get prices for a MRI. All that I could get from the providers was the billed amount they would charge and to call your insurance company for the actual price. I tried talking to my insurer and they told me what my benefit plan was, but to talk to the providers to get the actual price.
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Old 05-06-2016, 09:38 AM
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I thought it was a "known issue" in healthcare that trying to find prices is a fruitless endeavor.

I have tried to get prices for a MRI. All that I could get from the providers was the billed amount they would charge and to call your insurance company for the actual price. I tried talking to my insurer and they told me what my benefit plan was, but to talk to the providers to get the actual price.
And that's for a known service. For something like a birth with unknown factors, it would be more akin to getting an estimate on your car repair. They really can't tell you how much it would cost and giving estimates isn't part of their process.
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Old 05-06-2016, 09:50 AM
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Some good links here.
http://www.npr.org/sections/health-s...n-another-town

The best success I had was to ask which CPT codes the provider would use (from the provider) and then call my insurer and ask for the scheduled amount for that. That didn't work that well, but it worked better than anything else.

Another thing is United HC has a cost estimator, maybe your insurer has one too. When I looked it up for an emergency room visit, it didn't give me the cost of the doctor who later charged me though. Just the hospital part. But it was right on target with the hospital part of the bill, not that that was much consolation.
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Old 05-06-2016, 10:24 AM
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And that's for a known service. For something like a birth with unknown factors, it would be more akin to getting an estimate on your car repair. They really can't tell you how much it would cost and giving estimates isn't part of their process.
I do feel like hospitals could provide a range of prices for a scheduled birth; something like the average, 10th, and 90th percentiles. But there's a whole mess of complicating factors- The majority of people don't know how to interpret those numbers, Hospitals may not have the resources to store price information like this, and it would be another layer of admin to have a "financial advisor" (presumably not your doc/nurses) walk you through all of this.

Price transparency can only go so far as well. I know in the market for many items that higher cost = higher quality (in general). This equality holds much less for healthcare than the market in general.
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Old 05-06-2016, 10:30 AM
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I do feel like hospitals could provide a range of prices for a scheduled birth; something like the average, 10th, and 90th percentiles. But there's a whole mess of complicating factors- The majority of people don't know how to interpret those numbers, Hospitals may not have the resources to store price information like this, and it would be another layer of admin to have a "financial advisor" (presumably not your doc/nurses) walk you through all of this.

Price transparency can only go so far as well. I know in the market for many items that higher cost = higher quality (in general). This equality holds much less for healthcare than the market in general.
Exactly. People would probably intentionally choose higher priced services believing price is tied to quality. I mean, would you put your kid under the knife of the cheapest surgeon in town?

And to your first point, no they couldn't. Some plans have a single copay per admit, some are copays per day perhaps up to a max, and some are % of allowed (and probably half a dozen others I don't even know about, plus combinations of those three). Hospitals don't keep all that information to be able to apply it for you, they don't know where you are in your deductible etc. It could be fairly misleading if they did.
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Old 05-06-2016, 11:55 AM
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I do feel like hospitals could provide a range of prices for a scheduled birth; something like the average, 10th, and 90th percentiles. But there's a whole mess of complicating factors- The majority of people don't know how to interpret those numbers, Hospitals may not have the resources to store price information like this, and it would be another layer of admin to have a "financial advisor" (presumably not your doc/nurses) walk you through all of this.

Price transparency can only go so far as well. I know in the market for many items that higher cost = higher quality (in general). This equality holds much less for healthcare than the market in general.
Re the bolded: Perhaps the insurer could handle this, as it is in its best interest to keep its costs down as well.
I think they're called "case managers," but they are only used in high ROI situations.
So, who wants to buy my idea of small-case managers?
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Old 05-06-2016, 12:57 PM
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And to your first point, no they couldn't. Some plans have a single copay per admit, some are copays per day perhaps up to a max, and some are % of allowed (and probably half a dozen others I don't even know about, plus combinations of those three). Hospitals don't keep all that information to be able to apply it for you, they don't know where you are in your deductible etc. It could be fairly misleading if they did.
I meant they could give you the charges on an allowed basis, and leave it up to you to figure out your portion of the cost sharing. Again this assumes the majority of people have a working knowledge of the system (which they don't).
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Old 05-06-2016, 01:05 PM
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The hospital my wife registered with (where her OBGYN has privileges) sent us an itemized estimate for a birth with no complication and 2 days in the hospital. They also had someone call me (my wife put me down as the person financially responsible and checked the box for the call) to discuss costs, they gave me the cost to me after insurance (assuming some amount for the OBGYN global), and also the additional cost for a C-Section if it were necessary. They also worked before she gave birth to let me know their payment options and offered to work out exactly what I'd owe with my insurance benefit if I was concerned (didn't need it as I work at my insurance company).

They were super helpful and it was really great to have all of the $ figured out before baby arrived.
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