Ever Asked a Hospital What a Procedure Costs Them?

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Can the cost of a hip replacement in Philadelphia really vary from $11,000 to $125,000?

From white papers to published books, much has been written about how difficult it can be to find out what a hospital stay or outpatient procedure will cost. And as Anna Wilde Mathews observed in her article Lifting the Veil on Pricing for Health Care, the mystery surrounding healthcare pricing stems partly from the fact that hospitals and other providers generally don’t publicize how much they’re paid for services, which varies depending on who’s footing the bill.

Much has changed recently. And while it is difficult for websites like healthcarebluebook.com to quote exact pricing, they do suggest what a reasonable price should be based on what insurance carriers have paid hospitals for certain procedures in a certain geographic region.

It’s easy to understand why hospitals are reluctant to share price information. Consider the results of a study on hip replacement surgery published by JAMA Internal Medicine. According to Dr. Joseph Bernstein, professor of orthopedic surgery at the University of Pennsylvania, while more than half of the 120 hospitals surveyed could not provide a cost for the surgery, those that did quoted prices ranging from $11,000 to $125,000.

How can your health plan achieve price and quality transparency? Treat healthcare expenses like other business expenses! Self-fund with Medicare Reference Based Pricing and partner with a TPA that has the willingness and know-how to hold providers accountable.

These are today’s keys. These are the things we do for our clients each and every day. To take control of your healthcare costs, give us a call at your convenience.

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