Need prices for care? Hospitals urge asking

yamaro@mercedsunstar.comApril 2, 2013 

— California received a D for the transparency of its health care costs, but local hospital officials said cost information is available to patients when requested.

The study released this week by the Catalyst for Pay Reform and Health Care Incentives Improvement Institute graded each state based on its price transparency laws. Only Massachusetts and New Hampshire received an A.

Bob McLaughlin, spokesman for Mercy Medical Center, said all of the hospital's charges are reported to the Office of Statewide Health Planning and Development every year.

The state office then makes the information available on its website.

Patients can request estimates of charges for elective procedures, or nonemergency surgeries, McLaughlin said.

"We have financial counselors to help patients," he said.

Hospital officials recommend that patients contact the hospital's financial counselors before getting nonemergency procedures to determine the estimated charges, McLaughlin said.

Most of Mercy's prices are right in the middle compared with other hospitals, he said. However, some can be a little more or less.

For example, the average cost for a level-two -- low to moderate severity -- emergency room visit at Mercy is $633. The average cost for a level-three visit -- moderate severity -- is $1,265 and the average cost for level four -- high severity -- is $2,106, according to the state's 2012 data.

The prices for laboratory and pathology services at Mercy range from $68 for a urinalysis without microscopy to $660 for a comprehensive metabolic panel, the data show.

The prices on the surgery services at Mercy range from $4,422 for a diagnostic colonoscopy to $20,802 for a laparoscopic cholecystectomy, according to the data.

Craig Baize, spokesman for Sutter Health, owner of Memorial Hospital Los Banos, said the hospital is required to maintain and publicly post a list of charges for each service or item in a price file -- or the chargemaster.

"However, the amount we get paid by various payers -- Medicare, Medi-Cal, Blue Cross -- can vary widely and do not usually reflect the chargemaster price," he said.

The hospital reports pricing to its patients and potential patients through direct inquiry, Baize said, because more accurate information can be given after knowing which health insurance the patient has and the expected treatment.

"Exact charges, however, are difficult to provide because each course of treatment is unique with different costs for individuals in each care setting," he said.

Memorial Hospital Los Banos also reports its pricing to customers via the Office of Statewide Health Planning and Development, including its official chargemaster, which is a list of charge amounts for 25 common outpatient procedures -- required by Assembly Bill 1045, Baize said.

It also provides the estimated annual price increase, weighted for volume and revenue increases, he said.

The average cost for a level-two emergency room visit at Memorial Hospital Los Banos is $575. The average cost of a level-three visit is $1,575 and a level four is $2,412, according to the state's 2012 data.

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