Heritage Valley Health System would be 1st in region to post prices of procedures
By Luis Fábregas
Published: Thursday, Jan. 30, 2014, 11:36 p.m.
One of a hospital's most tightly guarded secrets soon could be at your fingertips.
Heritage Valley Health System expects to become the first in the region to post on its website its hospital fees for 25 common outpatient medical procedures, officials said on Thursday. No date for the posting was set.
The health network, with hospitals in Sewickley and Brighton, said it wants to be more transparent because of a growing number of uninsured people in its service area. The posted fees apply only to patients without health insurance, officials said.
“This will provide self-pay consumers the opportunity to know what the payment requirements would be in advance of the procedure,” said Bryan Randall, vice president and chief financial officer at Heritage Valley. “We as a health system believe pricing transparency is a benefit to the consumer and an important part of the health care decisions patients and families will be making.”
Some insurers use tools that allow members to calculate how much they'll pay in out-of-pocket costs. However, the region's largest health care providers, UPMC and Allegheny Health Network, do not post prices.
Spokesmen for those systems could not say whether they plan to reveal prices.
“We are currently assessing strategies for effecting greater price transparency across the network,” said Allegheny Health spokesman Dan Laurent.
Advocates for the uninsured praised Heritage Valley's decision, because even with the federal health care law that provides tax credits to those seeking insurance, some people might not qualify for coverage.
“It seems like this is something that would help educate consumers about the cost of health care,” said Antoinette Kraus, director of the Pennsylvania Health Access Network. “The more transparent we make the health care system, the better it is for everyone.”
Kraus estimated that about 400,000 Pennsylvanians will remain uninsured because Gov. Tom Corbett opted out of expanding the Medicaid program as suggested by the federal Affordable Care Act. The federal Department of Health and Human Services is reviewing Corbett's alternate proposal to use additional money for Medicaid to buy private insurance for the poor.
The costs for medical procedures have long been debated. In its 2011 award-winning investigative series “Code Green: Bleeding Dollars,” the Tribune-Review reported the cost for the same medical procedures can vary wildly not only by region and state, but within the same city and even in the same hospital, depending on whether the cost was covered by insurance or self-paid.
Examples of Heritage Valley's patient fees for the self-insured are $215 for a screening mammography and $832 for an MRI of the chest, Randall said. He cautioned that the numbers represent hospital fees and do not include physicians' fees that are typically billed separately.
Stephen Foreman, associate professor of health administration at Robert Morris University, said he hopes Heritage Valley can encourage physicians to post prices for common procedures, too.
“This is a very good thing,” Foreman said. “Hopefully, it will work for patients, to the extent that Heritage expands it, and other hospitals and systems will follow suit.”
It is not the first time Heritage Valley has revealed prices. The hospital network posts prices for its seven ConvenientCare clinics. Prices range from $59 for treatment of a sore throat to $4 for a glucose test.
Highmark Inc., the region's largest insurer, last year introduced an online cost estimator for members of some plans, said spokesman Doug Braunsdorf. Consumers can determine how much they'll pay for procedures at specific hospitals, based on their deductibles and other factors, he said.
“We've championed transparency in health care for a long time,” Braunsdorf said. “We think it's important for consumers to have a full sense of what health care costs.”
Luis Fábregas is Trib Total Media's medical editor. Reach him at 412-320-7998 or firstname.lastname@example.org.
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