How much is my surgery going to cost?
Mercy and West Valley medical centers in Canyon County are peeling away some of the mystery of pricing by going online with price tags for everything from delivering a baby to having a knee replaced.
It’s one sign of a trend in the Treasure Valley and nationwide of "transparency," the buzzword for a push and a shove toward making prices, doctor ratings, treatment outcomes and other data easier for consumers to get.
It won’t make shopping for health care quite like shopping for a car, but it is expected to help keep health care costs in check and lead to improved treatments in the long run.
What will my hospital stay cost?
The state’s biggest hospitals, in Boise and Meridian, are not posting prices on the Internet but are willing to work out estimates for people who call during business hours.
St. Luke’s Web site has a phone number, 706-7660, to call for price information from 8 a.m. to 5 p.m. weekdays. At Saint Al’s, you can call 367-2130 from 8 a.m. to 4:30 p.m. Monday through Friday.
St. Luke’s opted against posting prices online because the amount patients pay out of their own pockets varies a lot, depending on their health insurance.
"We decided patients are better served by calling us and getting a price quote tailored to their situation, so there aren’t any surprises," St. Luke’s spokesman Ken Dey said.
"That may not be as convenient as online quotes, but we feel it’s more transparent because patients have an accurate price quote and one that isn’t subject to a long list of disclaimers," he said.
Saint Al’s likes the idea of posting prices online and hopes to give it more serious consideration after the hospital finishes a huge, time-consuming computer system change, said Mike Frith, director of business services at Saint Al’s. Until then, the hospital is trying to provide more information over the phone, including patients’ portion of the bill, after insurance pays its share.
The large general hospitals in Canyon County chose a different path. On the right-hand side of the home page on Mercy’s Web site (mercymedicalnampa.com), you will find a list that includes "procedure estimates."
Click on it, and agree to disclaimers that the prices don’t take into account your insurance or physician charges.
The hospital provides median, low and high charges for dozens of procedures, including noninvasive, laparoscopic removal of the gallbladder with no overnight hospital stay. The median hospital charge is $5,263.65.
Mercy took the step more than a year ago with little fanfare because its parent company,
the nonprofit Catholic Health Initiatives, decided to make price transparency a priority.
"This was intended to make it easier for patients to determine the costs of a variety of procedures so that they could make an educated decision about their health care," Mercy spokeswoman Mary Buchanan said.
The hospital’s financial services department can help you figure out how much your health insurance will pay.
In Caldwell, West Valley Medical Center, part of the for-profit hospital chain HCI, offers price estimates (westvalleymedctr.com)
if you click on a link for people without
insurance.
If you click on the link for people with insurance, you will get some information and a number to call to help figure out how much you will pay and how much your insurance will cover.
"Although no pricing guarantees are possible, we think this tool provides a much better answer to the question, ‘How much will it cost?’ " West Valley spokesman and state Sen. John McGee said.
Doctor bills
Your doctor may send a bill to your house after your appointment or ask for co-pays or other fees before you leave the office. Many doctors who perform elective surgery ask for their money up front, before you go under the knife. But perhaps nowhere are prices clearer than at the basic medical clinics scattered across the Treasure Valley in retail businesses.
For example, the Wal-Mart supercenter store in Caldwell has a Primary Health clinic where the average price, $55, is posted, along with a list of basic medical services you get for your money. That list includes treatment of sinus infections, ear infections, coughs and colds and other conditions. The clinic will bill your health insurance.
Health insurers
Regence BlueShield of Idaho has an online treatment cost adviser, a tool that gives customers access to average costs where they live. Customers can get cost information on treatments related to children’s health, dental services, joint problems, men’s health, women’s health, mental health and other topics.
The company unveiled a Web site,
whatstherealcost.org, that discusses health care costs and how people can help control those costs, spokesman Mike Tatko said.
Blue Cross of Idaho, the state’s largest health insurer, also has a treatment cost tool on its Web site. It estimates costs for hundreds of common conditions, procedures, tests and health-care visits, said Stewart Johnson, spokesman for Blue Cross of Idaho.
The insurer’s "hospital quality compare" tool lets people with Blue Cross of Idaho insurance get pricing and other information for specific procedures, on selected hospitals.
Members’ out-of-pocket costs depend on their health plan benefits and whether their plan covers the service.