Northland hospitals post charges online
For everything from 10-cent magnets to $100,000 surgeries, hospitals now are required to list their charges online.
But don't expect it to be like shopping for video games on Amazon.
"I work in the industry, and I would admit that I have a hard time understanding these chargemasters," said Eric Hoag, vice president of provider relations for Blue Cross and Blue Shield of Minnesota.
"Chargemaster" is the term for the breathtakingly long list of dressings, drugs and devices now attached as PDFs to hospital websites. Beginning Jan. 1, the Trump administration required hospitals to post the lists in an extension of rules from the Affordable Care Act, according to Kaiser Health News.
There's currently no penalty for failure to comply, the news service added.
In spite of that, a look at regional hospital sites found all to be in compliance. But consumers won't find an easily identifiable link on the hospital's homepage.
From the Essentia Health homepage, for example, select "Patients & Visitors." Then under "Paying for Care," click on "billing and financial assistance." Then, under "Charges for Essentia Health Services," click on the link (highlighted in blue), that begins, "full list of our hospitals." Choose the hospital you want, click on it, and the price list will download to your computer.
Click on that, and the list of prices will pop up. It will be helpful if you have a spreadsheet program and know how to use it, because the charges aren't arranged by price, or alphabetically.
From the St. Luke's homepage, click on "Visitor Information." When that page comes up, click on "Financial Services." You'll find "Chargemaster" about halfway down that page, and you'll have a choice of going to St. Luke's or Lake View (Two Harbors). Then click on "Charge Description Master File." As with Essentia, that will send a download of the charges. When you open it, you'll find the charges arrayed from lowest to highest.
The layperson might see the listed items as being about as clear as Egyptian hieroglyphics. What is one to make of "RPR7 House Dust Mites/DF lgE" ($19.95, St. Luke's)? Or "Screw synt lck S-tap strdrv 2x10 M201.880 ($350, Essentia Health-St. Mary's Medical Center)?
Also, the terminology may not be directly comparable from one hospital to another. Is MRI Chest W O Contrast ($2,000, St. Luke's) the same as MRI Chest w/o TC ($2,062, St. Mary's)?
Nonetheless, listing the charges has value, said Dr. Paula Termuhlen, Duluth campus dean for the University of Minnesota Medical School.
"I think it has great value," said Termuhlen, who also practices at Essentia Health. "It helps everyone understand the price of health care."
It also can help consumers make informed decisions, she said.
"Depending on the health plan and deductible, it does give you an opportunity to decide where can I afford to get that done, particularly in the case of testing, or in some instances where to get a procedure done," Termuhlen said.
She noted that health providers in some parts of the country already have gone further toward making their prices known. In the Indianapolis area, Termuhlen said, medical providers have billboards announcing their prices for certain procedures.
Katherine Bisek, vice president of strategic initiatives for UnitedHealthcare, said that insurer "believes all people should have access ... empowering them to comparison shop for health care like other products or services."
Essentia Health spokeswoman Maureen Talarico said the charges on the list are the dollar amounts Essentia sets but may not be the actual price because of discounts negotiated with insurance companies.
That is also true at St. Luke's, a spokeswoman said.
Bisek said UnitedHealthcare takes that into account when it provides customers with information about actual costs personalized for them. Duluth customers, for example, face a wide variation in costs for common medical services:
- From $530 to $3,140 for a knee MRI
- From $12,170 to $31,160 for a Caesarean section
- From $56,530 to $81,200 for back surgery (lumbar fusion)
There's more to choosing a provider than price, Bisek acknowledged — unless there isn't.
"For certain services like MRIs there typically isn't a quality aspect to it," she said. "There's no corresponding improvement in health outcomes."
Blue Cross' Hoag is less sanguine about the new lists of charges.
"At Blue Cross we are absolutely supportive of greater transparency in health care," he said. "The limitation is in what is being put out there."
Because the charges often won't be what patients and their insurers actually pay, they don't in themselves provide the information that is truly useful, Hoag said. "I would probably put minimal meaning to it if I was shopping for myself."
Like UnitedHealthcare, Blue Cross tries to provide tools to help its members make meaningful choices, he said. Sometimes, that can include questioning whether a particular service is needed.
He cited a 2012 Institute of Medicine finding that 30 percent of U.S. health care spending — about $750 billion at that time — is wasted.
"We're working with providers to make sure, first, is the service necessary?" Hoag said. "If somebody goes in and gets a CT scan that is not necessary, they've just received the equivalent of 100 X-rays."
But Termuhlen said the charges in themselves comprise a tool that consumers can use.
"The way you navigate that in a community the size of our community is to say: If this test costs more here, why? Why do I need to stay here? Or can I go to the other system?"
Consumers should evaluate both quality of care and cost to make informed decisions, Termuhlen said. In Minnesota, MN Community Measurement provides an array of price and quality comparison for clinics, medical groups and hospitals at its Minnesota HealthScores website.
Don't be afraid to challenge your provider, she added.
"I have patients that bring me their bills and ask me their questions," she said. "And sometimes I learn things from patients that I didn't even know about care that I delivered."
To learn more
Compare ratings on the quality and cost of health care in Minnesota and neighboring areas, visit mnhealthscores.org.