By CHAD TERHUNE
Michael Foley had a feeling it would be difficult to get a bargain price for an endoscopy, but just getting a quote from his local hospital turned out to be a surprising hurdle. According to the 49-year-old contractor from Freeland, Wash., the hospital declined to discuss specific prices on the phone. It did agree to send a range in writing, and quite a range it was: from $2,360 to $22,290, excluding physician charges. "If we all billed like that, we'd be millionaires," Foley says. (A Whidbey General spokesperson says the hospital gives a broad price range for surgeries to cover complications that may occur.)
As anyone who's ever been sick knows, finding the best price for a medical procedure can be as hard as, well, being sick. And experts say health care costs will matter even more going forward, as companies continue to raise deductibles and require workers to pay more for hospital stays and tests -- trends some pros say could accelerate. But while most of the country's attention was focused on health care reform, an odd combination of state laws, pressure from the insurance industry and research by private websites has been quietly forcing the medical industry to divulge more details on pricing. The change is happening gradually, but consumers who want more information might actually be able to get it. Web firms like Pricedoc.com offer price quotes on annual exams and some elective procedures. And 30 states now require hospitals to disclose some prices, nearly twice as many as in 2005, according to the National Conference of State Legislatures.
To be sure, consumer advocates warn much of the data is too generic or confusing: Some hospital associations publish prices far higher than the rates insurers and patients are typically charged, many sites offer average prices in a given area without naming providers or adjusting for specific insurance plans, and online quotes can fail to include the thousands of dollars anesthesiologists and other specialists tack on. "The lack of comprehensiveness is a problem around the country -- average prices don't really matter," says Maribeth Shannon, a program director at the California HealthCare Foundation.
Still, more firms are cropping up to offer services that help consumers wade through the health care morass. For example, Milwaukee-based consumer-advocacy group Patient Care, which assists 1.5 million workers and dependents, checked prices last year for someone needing arthroscopic knee surgery; the prices at four Baton Rouge, La., medical facilities ranged from $4,500 to $14,500. Consumer requests for information have doubled in the past 18 months, the firm says. But even with some state laws requiring hospitals to disclose pricing, experts say it's not always done. "States are so distracted by their budget crises, most of these laws aren't enforced," says Jane Cooper, chief executive of Patient Care.