KSNV: SPECIAL REPORT: The Cost of CareKSNV: SPECIAL REPORT: The Cost of Care
Washington, DC,
April 26, 2019
“The medical language is just so confusing. There are so many acronyms, so many numbers, so many abbreviations you don't really know what it means. And the fourth thing is, it's never really exactly what you get charged because each patient is different”, says Representative Dina Titus.
We've been hearing a lot lately about transparency in medical costs. In fact, the U.S. Department Of Health and Human Services put some new rules into effect on January 1, requiring all hospitals to post their prices online. We have been looking into the reasons for the new rules and what it means to you. The main reason for making hospitals post the cost of everything, from procedures to pills, is to help you shop around for the best price before you decide where to go for your healthcare. The common misconception is that if you bargain shop, hospitals might be inclined to lower their prices, but in this case, it's not nearly as simple as it seems. Since the beginning of the year, every hospital in America was required by H.H.S. to post their prices online whether it be prescriptions or robotic surgery; so you could shop for the least expensive option. “In theory, it gives consumers the ability to compare. Unfortunately, the reality is a little different than the theory”, states Dr.Michael Gardner, Vice Dean of UNLV School of Medicine. That's because the hospital's posted price online is rarely what you'll end up paying because it doesn't factor in a big wildcard, your insurance. Here's an example. I've pulled the price list from two local hospitals. The one on the left lists the price of a 325-milligram aspirin for $13. The one on the right has it for only $2. However, depending on my insurance, the $13 aspirin might only end up costing $1 after coverage kicks in. And that's not the only confusing part. “The medical language is just so confusing. There are so many acronyms, so many numbers, so many abbreviations you don't really know what it means. And the fourth thing is, it's never really exactly what you get charged because each patient is different”, says Representative Dina Titus. Federal lawmakers are already aware of the problems. “I think you will see us move forward with something mandating that they come up with a regulation like that.”, says Titus. But until that happens, what's the best way to price shop for your healthcare? “Work with your insurance company. They have negotiated contracts with hospitals, and the best place to start would be with them because they can give you the most information on what they're covering for your procedure”, says Amy Shogren the Director of Communications Nevada Hospital Association. If you're considering elective surgery, make sure your insurance covers everyone in the operating room. “What you also want to know is, is your surgeon who's doing your case, are they in your plan. Is there gonna be a co-pay there, And here's the one that gets people. What about other people? What about the pathologist who reads your biopsies, are they in your plan? What about anesthesia?”, explains Dr.Gardner. Dr. Gardner says the online list shouldn't be the endpoint. It should be the starting point, and it's in your insurance company's mutual interest to help you find the lowest cost. The list is definitely better than no information, but pretty much everyone agrees it needs uniformity and simplification. |