How to comparison shop when for hospitalsback
FORT MYERS, Fla. -- If you need to get a cervical spinal fusion you can head to Lee Memorial Hospital where the average cost for that procedure is $61,000. At Naples Community Health, the same procedure is only $37,000. And at the Charlotte Regional Medical Center the average charge is $113,000.
Before now you could likely get these figures by calling the individual hospital, but thanks to a new federal database, you can access the master list of prices, or what's called a chargemaster, for the 100 most common inpatient procedures.
Even with this information, medical billing advocate Sheri Samotin says, "the important thing however, is that virtually nobody pays the charge."
That's because Medicare and private insurance companies typically negotiate lower charges.
For instance, even though the maximum charge for a permanent cardiac pacemaker implant with complication is $49,000 at Naples Community and $128,000 just down the road at Physicians Regional. If you have insurance you'll pay significantly less. Usually about $15,000 and $18,000 respectively.
"It's a very complex calculation," said Samotin, the President of LifeBridge Solutions in Naples, "there's consultants who earn their living helping hospitals set their chargemaster."
Local hospitals contend that these figures aren't relevant to consumers. After all, even if you don't have insurance hospitals will work with you to lower the price.
We should also point out that the database shows the average costs paid by consumers, which are roughly the same at every local hospital.
"Choosing a hospital is an important decision that should not be based on cost alone," said Lee Memorial Spokesperson Mary Briggs, "quality of care and patient safety are even more important considerations. When making this choice we suggest you get recommendations from trusted friends and your physicians."
But the Obama administration sees the new list as a tool for consumers. In a statement, Health and Human Services Secretary Kathleen Sebelius said "consumers don't know what a hospital is charging them or their insurance company for a given procedure. This data and new data centers will help fill that gap."
"Having data helps providers, whether hospitals, individual physicians, whatever, evaluate their behavior, how they do what they do, and improve," Samotin said.
There is one figure on the new list that Samotin says all consumers should check before they have a procedure. It's not the price, but instead the total number of surgeries the hospital performed.
"I'd rather go to a surgeon and to a team that's doing a whole lot of whatever it is I'm having."
You can download the database at: http://cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Medicare-Provider-Charge-Data/Inpatient.html