Patients Can Compare Surgery, Hospital Costs
State Of Texas Does Not Provide Hospital Comparison Costs
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Cost Comparisons:
- Texas Hospital Checkup (nonprofit group that compares Houston-area hospital prices): http://tbgh.org/checkup/ State Of Wisconsin Hospital Cost Comparison: www.dhfs.state.wi.us/healthcarecosts/index.htm Kentucky Hospital Association's Cost Comparison: https://www.kyha.com/Pricing/main.asp
Response From Texas Hospital Association:
- Why can't consumers compare prices for hospital procedures? Why is it so complicated? Answer: Consumers can compare prices, but be aware that the average "charge" or the "range" of charges may not help much. In reality, what the patient needs to know is what coverage is provided by his insurance plan, if the provider is part of the health plan's "network" and what his co-pay or deductible amounts are.Hospitals can and do provide estimates for elective procedures. One of the problems in providing an "estimate" is the uncertainty of exactly what the doctor will prescribe and how the patient will respond to the ordered treatment/medication.It's easy for consumers to know how much it costs to buy clothing, food and most other products and services. Unfortunately, purchasing health care is not like buying a car. When you buy a car, you choose exactly what options come with the car. You don't choose when to get sick or injured, and you may or may not choose where to go for health care services and which doctor cares for you.A doctor, not the consumer, orders the "service options" you receive. If you are insured, your health insurance company decides how much you have to pay, and how much providers are reimbursed for services. And, if you do not have insurance and do not qualify for financial assistance programs, the hospital cannot give you a discount because of current state law.Health care is different, and is a lot more complicated than buying a car or something at Wal-Mart.Are there plans to make billing more transparent in the near future? What are some of the steps hospitals are taking now? Answer: Legislation is moving that would require hospitals and the Texas Health Care Information Collection to post the average charge for the 50 most common procedures. It also would require hospitals to provide cost estimates upon request prior to non-emergent hospital admissions or prior to scheduled outpatient procedures. In addition, hospitals, health plans and some hospital-based providers (such as anesthesiologists, pathologists and radiologists) will be required to notify patients that some of these physicians are not included in the health plan's network and may bill for the balance not paid by the insurer.Hospitals now provide cost estimates for elective procedures upon request, as well as work with low-income, uninsured patients to qualify them for Medicaid or charity care. Hospitals also will work with patients to establish time-payment plans. Hospitals continue to try to make their statements and the bill process more patient-friendly.In addition, THA requested legislation to remove the prohibition on hospitals' offering discounts to uninsured patients. The Legislature is poised to approve this legislation and give hospitals flexibility to work with uninsured patients.
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