UPDATED: Lotsa luck finding the cost of medical services
Wednesday, December 2, 2009
If you’re a Californian who doesn’t have health insurance, state law requires hospitals to give you an estimate as to how much a medical procedure will cost.
It’s a law that, apparently, most hospitals don’t observe.
In a study conducted by researchers from the RAND Corporation, the California HealthCare Foundation and two universities, only 28% of California hospitals that were asked for an estimate by an uninsured consumer provided a response…and not all of them provided a price estimate. Of those that did, some did not include the additional cost of physician services; others didn’t specify exactly what their estimate covered. Only 10 of 353 hospitals contacted provided a price estimate that explicitly covered both hospital and physician costs.
Not only is it almost impossible for uninsured Californians to do any price-comparison shopping for health care, as required under the state’s transparency law, many of the price estimates that are offered may be illegally high. From the RAND news release:
While California law says the uninsured cannot be charged more than a hospital is paid by a government health plan, two-thirds of the price quotes exceeded the median price that Medicare reimburses hospitals for each of the procedures in California. The finding suggests most hospitals provided estimates higher than what they are allowed to charge under state law.
However, the requirement that the uninsured be required to pay no more than the government health plan rate applies only to low-income Californians. RAND officials said the queries that were sent in this survey did not specify the income of the patient, only the fact that the patient was uninsured, so hospitals didn’t necessarily know a price ceiling applied.
For those who do price-shop, the savings can be enormous. Price estimates provided for a hysterectomy ranged from a low of $5,569 to a high of $15,950. And the highest estimate for a colonoscopy was more than eight times the lowest estimate.
Asked why so few hospitals provided the required information, a California Hospital Association spokeswoman told the Sacramento Bee, “I’m not going to justify or defend it. All hospitals have to comply with what the law says.”
UPDATE: Spencer Sherman of Catholic Healthcare Foundation sent the following correction:
I’m writing to ask you to correct an error in your story … It was not your error, but an error contained in the RAND press release. CHCF was not involved in the study, as your story states. A staff member at the Foundation, acting as an independent researcher, was part of the study team. However, CHCF provided no support or funding for the report and does not necessarily support its conclusions.