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follow zzyzzx 2013 Feb 12, 1:36am
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Consumers looking to buy a new car or a computer can shop around for the right price, but when it comes to health care, it's difficult to even find out ahead of time how much a procedure will cost. And when patients do find out, the cost can vary by thousands of dollars, depending on the hospital, according to a study released on Monday.
Researchers at the University of Iowa set out to see if they could learn, and then compare, the price of a common procedure -- hip replacement -- at hospitals across the United States. Of those they surveyed, only 16 percent could immediately provide a complete price, including the doctor's fees and hospital costs, for the procedure. And 47 percent of the hospitals came up with a figure only after health care providers were separately contacted.
When price estimates for the widely performed procedure were given, they ranged from $11,100 to $125,798, reported the study, which was published by the Journal of the American Medical Association in its publication, JAMA Internal Medicine.
â€œHospitals still have a long way to go to provide total transparency in pricing,â€ Jaime Rosenthal, one of the study's authors, told NBC News. â€œIt was surprising, we either didnâ€™t get the information, or it was extremely difficult to get.â€
Rosenthal, of the University of Iowa Carver College of Medicine, in Iowa City, and colleagues randomly selected two hospitals from each state and Washington, D.C., that perform total hip replacements, as well as 20 top-ranked orthopedic hospitals, to request the â€œbundled priceâ€ for the procedure for an uninsured patient with the financial means to pay out of pocket. She said they chose to survey hospitals on hip replacement because it is a common procedure with over 200,000 performed each year in the U.S.
â€œWe found that price estimates varied nearly 10-fold across hospitals, which is surprising considering that all hospitals were provided with standardized information about the procedure being requested,â€ researchers wrote in the study.
According to the results, nine top-ranked hospitals (45 percent) and 10 non-top-ranked hospitals (10 percent) were able to provide a complete bundled price. Researchers also were able to obtain a complete price estimate from an additional three top-ranked hospitals (15 percent) and 54 non-top-ranked hospitals (53 percent) by contacting the hospitals and physicians separately.
At top-ranked hospitals the complete price ranged from $12,500 to $105,000 and at non-top-ranked hospitals prices ranged from $11,100 to $125,798, according to the study results. â€œOur results demonstrate that many health care providers are not able to provide reasonable price quotes,â€ the study concludes.
â€œThere is no justification for the inability to report a fee estimate, or a 12-fold price variation for a common elective procedure like a hip replacement,â€ wrote Andrew Steinmetz and Dr. Ezekiel J. Emanuel of the University of Pennsylvania, in a related commentary to the study.
He compared it to the used-car business. â€œThey only want to know what you can pay," he said. "At least when you are buying a car, you can walk away.â€
I wish I could do that with dental work, but everything expensive requires multiple visits.
professional fees are set by 3rd party payers...medicare, medicaid and the VA pay for about 70% of the health care in the US. It's the hospitals that provide these wildly variable numbers. Ask a doc what his charges are for an aortic valve replacement? what's he going to tell you? what's a heart surgeon worth for the hours of pre operative consultation, the 4 hours of surgery, and the several hours each day managing your intensive care period? a couple thousand bucks maybe?