Monday, April 23, 2012

Hospital ripoffs

Hospital charges are all over the map: according to the report published Monday in the Archives of Internal Medicine, fees for a routine appendectomy in California can range from $1,500 to — in one extreme case — $182,955. Researchers found wide variations in charges even among appendectomy patients treated at the same hospital.

“We expected to see variations of two or three times the amount, but this is ridiculous,” said Dr. Renee Y. Hsia, the study’s lead author and an assistant professor of emergency medicine at the University of California, San Francisco. “There’s no rhyme or reason for how patients are charged or how hospitals come up with charges.” ....

Hospital charges appear on patients’ bills, but they often bear no relation to the discounted fees that an insurer will end up paying. Still, some patients do get stuck paying the retail price. They include the uninsured, those with bare-bones or high-deductible plans, and even some fully insured people like Mr. Hong. ...

After reviewing all the cases and accounting for individual variations in health, Dr. Hsia said one-third of the variation in charges still could not be explained.

The wide range of hospital prices isn’t limited to appendectomy. In 2007, researchers at the University of Pittsburgh and elsewhere posed as patients trying to get pricing information from hospitals in advance of a procedure, a right under California state law. Hospital hysterectomy charges ranged from $3,500 to $65,300, the researchers found. Gallbladder removal charges ranged from $2,700 to $36,000, and a colonoscopy screening might cost anywhere from $350 to $5,805.

Fewer than one-third of the 353 hospitals that were queried even responded to requests for pricing information. Those that did often did not provide all the information requested or say whether physician fees were included, said Dr. Ateev Mehrotra, an assistant professor of medicine at University of Pittsburgh School of Medicine and a RAND policy analyst who was the senior author of that study.
--Roni Caryn Rabin, NYT, on the nonsense of hospital bills