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St. Clair Hospital to offer patients early access to care costs

| Sunday, Feb. 21, 2016, 11:18 p.m.
St. Clair Hospital

A new tool from St. Clair Hospital helps people shop for health care the way they shop for everything else: by looking up what a service costs before agreeing to pay for it.

Hospitals rarely provide costs of surgeries, tests or other procedures before people get them done, leaving patients to learn what they owe when a bill shows up a month or more after a hospital visit.

St. Clair's tool , set to go live on the hospital's website at 8 a.m. Monday, gives cost estimates for 105 procedures ranging from blood tests and X-rays to common surgeries such as a gallbladder removal and meniscus repair.

Competing with regional hospital systems UPMC and Allegheny Health Network, the independent Mt. Lebanon community hospital has focused in recent years on patient safety, aiming for high quality scores from the Centers for Medicare & Medicaid Services and independent hospital safety organizations such as The Leapfrog Group, said Chief Medical Officer Alan Yeasted.

The hospital also has focused on patient satisfaction scores, which CMS collects and uses to compare hospitals. The online cost estimator tool was developed in response to a common request from patients to know costs before undergoing a procedure, hospital officials said.

“There are many institutions in the United States — and in Pittsburgh — that have high quality. But we wanted to be able to do that at a very reasonable cost and to show people what it's going to cost to come here and what their actual out-of-pocket cost is going to be,” Yeasted said.

The tool is being offered amid a national trend toward higher annual deductibles, which some health economists say help control overall health spending by making consumers more responsible health care shoppers. The average deductible for a single person with an employer plan in 2015 was $1,318, up from $917 in 2010, according to an analysis from the Kaiser Family Foundation, a Washington, D.C.-based health research nonprofit.

But it is often more difficult for individual consumers than for businesses to find the costs and quality measures that would make them informed shoppers.

Many insurance carriers offer cost estimators based on aggregated patient bills, but few hospitals do. St. Clair's tool, built by information services company Experian, lets users enter information from their insurance cards and view their benefits in real time. Users can see how much of their deductible they have paid and factor the number into what they would owe for a given procedure.

The tool calculates what patients would owe the hospital for procedures, but it does not include what a patient would owe the physician specialists involved. That function could be added later, hospital officials said.

The hospital has provided cost estimates by phone for five years, the officials said, and decided which procedures to include in the online tool based partly on what people often asked about.

Wes Venteicher is a Tribune-Review staff writer. Reach him at 412-380-5676 or wventeicher@tribweb.com.

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