I really salute these guys for doing this. It's freakin' awesome. This I've added to my next letter to my representatives in Congress:<p><i>"Dr. Smith said federal Medicare regulation would not allow for their online price menu.
They have avoided government regulation and control in that area by choosing not to accept Medicaid or Medicare payments."</i><p>I've suggested that one non-controversial way in which Healthcare could be "reformed" would be to make it easier for hospitals to be transparent about their prices. Any sort of regulation that prevents hospitals from disclosing their prices is bad for the citizenry, please fix that part of the regulations.
I dream of a day when I can walk into an area which offers 'services' and be offered a pricing chart. From hospitals, banks, loan officers, home loans, cars, etc.<p>A cryptic itemized list, such as a mortgage's Good Faith Estimate (GFE), which falls short of describing the items in the list still fails my test.<p>This hope is not for me. Its for the misfortunate who run on impulse and have weak mathematical logic. Many people will nod their heads when you mention simple/compound interest or amortization. They will easily dig themselves into holes and take on the realization far too late in the game.<p>Another favorite which gets thrown in the air: 'Purchase this warranty.' Countless friends and family have worried that their purchase or lack of warranty was a mistake. Asking about said warranty usually results in: 'read the small text in the agreement.' Typically, walking away from the situation completely misinformed by a seller.<p>As I prepare to move out of my apartment, I received an itemized list (hidden among a contract and various other documentation) which in total amounted to $11,500 in charges for potential neglect in leaving the apartment. Simple things on the list: patch holes ($80/hole), steam clean carpet with receipt ($500/room), replace drip pan ($200), etc. Nothing warns you of the potential threat.
This happens <i>only now</i>? In more civilized countries like Germany, prices for procedures have been set since time immorial. There is a provision for surcharges from the physician, but these aren't common, and the physician will have to have a good cause or the insurer will not pay it.<p>Same thing for new medications: they are not permitted in the clinic unless there is a genuine advantage for the patient.<p>All this is of course due to political circumstances: medicine is just too profitable.
One thing to keep in mind is that there's more to good medical care than a fair price:<p>Post-op infection rate - do all clinical employees regularly wash their hands before and after each patient encounter?<p>Re-admission rate - does the institution or surgeon do enough cases of a particular procedure to be proficient?<p>Error Rate - Are pre-op checklists ALWAYS used?<p>Post-op care - Are supportive therapies like Physiotherapy available?<p>It bugs me to see medical interventions treated like a commodity, these "products" don't always follow generally accepted market principles - a price cut in colonoscopies will not significantly increase demand.
As someone with an High Deductible Healthcare Plan, I pay most medical costs out of pocket up to an annual limit. It's crazy that for such expensive services I NEVER know what my bill is going to be until months after the procedure has happened. I always try to guesstimate costs beforehand, but I've been off by an order of magnitude on more than one occasion. Having transparent pricing in the healthcare world, even if it was just an estimate, would help people with HDHPs immensely.
Let me start off with I worked in a medical billing office for the last 5 years and here are some things you'll never hear about:<p>Medicare pays only 15-25% of what they are charged, that is to say, if a surgery costs $40,000 they will only pay the doctor $10,000.<p>This isn't only medicare, it's literally every company. Every single insurance company pays only a fraction (usually 50%$ or less) of what the hospital actually charges you. If you don't have insurance you can just call up and usually if your semi-nice and fairly strait forward you can get the bill reduced to a fraction (30-40%) because that's about what they accept from insurance anyways.<p>Their prices are simply what they'll get paid in either case, so good job to these doctors, hope it helps less people get scammed and pay their full bills.
<p><pre><code> They have avoided government regulation and control in
that area by choosing not to accept Medicaid or Medicare
payments.
</code></pre>
I don't understand how the government itself is causing lack of price transparency, but this should be addressed by any president or congressman who imagines he's going to do something about healthcare costs. If you don't have price transparency, you have no chance at cost cutting.
Congress froze the number of Medicare-supported residency slots at 100,000 under the Balanced Budget act of 1997 [1]. The cap remains in place to this day, despite a massive shortage of physicians.<p>The AMA's official position in 1996:<p>"To decrease the rate of physician supply, limits must be placed on the number of medical school graduates entering GME [graduate medical education]. Since the federal government currently plays a major role in financing GME and is responsible for establishing immigration laws that affect IMG participation in GME in this country, it is imperative that the federal government partner with the medical education community to achieve this goal." [2]<p>The AMA worked closely with then Speaker of the House Newt Gringich to overhaul Medicare's relationship with physicians. [3]<p>The AMA is typically the biggest spender among lobbying groups in the health care sector.<p>[1] <a href="http://usatoday30.usatoday.com/News/health/2005-03-02-doctor-shortage_x.htm" rel="nofollow">http://usatoday30.usatoday.com/News/health/2005-03-02-doctor...</a><p>[2] <a href="http://www.ama-assn.org/resources/doc/PolicyFinder/policyfiles/HnE/H-305.968.HTM" rel="nofollow">http://www.ama-assn.org/resources/doc/PolicyFinder/policyfil...</a><p>[3] <a href="http://www.clintonlibrary.gov/assets/storage/Research%20-%20Digital%20Library/jennings-hsa/Box%20046/647904-hsa-congressman-gingrich-AMA-deal.pdf.pdf" rel="nofollow">http://www.clintonlibrary.gov/assets/storage/Research%20-%20...</a>
Mercy Hospital charged $16, 244 for a breast biopsy; the procedure will cost $3,500 at Surgery Center of Oklahoma.<p>WTF?!? I don't know what we charge for a routine biopsy, but for an MRI guided one with vacuum assistance - vasty more complicated, expensive and time consuming - we charge about $2000USD.
Come and have a holiday in New Zealand at the same time and it may still be cheaper.
In Singapore it's required for all hospitals to post their prices and they have some of the lowest health care costs around. This should be mandatory in the United States.
"Dr. Smith said federal Medicare regulation would not allow for their online price menu.<p>They have avoided government regulation and control in that area by choosing not to accept Medicaid or Medicare payments."<p>This is simply not true. If they were undercutting Medicare with their pricing, the government would likely have issue with it (i.e. if they were contracted with Medicare but charging Medicare more than what they charge other insurers/patients - this never happens). But their pricing is multiple times what a Medicare claimant would have to pay, so it's a non-issue.<p>Take, for example, the One Medical Group. They accept Medicare and although the services they provide are limited to primary care, they are transparent with their basic fees.
<a href="http://www.onemedical.com/nyc/pricing/insurance" rel="nofollow">http://www.onemedical.com/nyc/pricing/insurance</a><p>Our own medical group is heading in the direction of transparent pricing as well, and we accept Medicare.
The article uses the term "bidding war" like it's a race to the bottom.<p>Isn't clear pricing supposed to be a good thing? Shouldn't it be actually <i>enforced</i> by law?
Great story but<p><i>"OKLAHOMA CITY – An Oklahoma City surgery center is offering a new kind of price transparency, posting guaranteed all-inclusive surgery prices online. The move is revolutionizing medical billing in Oklahoma and around the world."</i><p>Around the world? Really?
One of the major problems with U.S. healthcare is that, financially speaking, patients have been increasingly taken out of the mix beginning in the fifties. Providers and insurance carriers shield consumers from actual costs giving a false impression of the value of competent healthcare.
Insurance companies’ reimbursement rates are a fraction of the billed amount. Of course, it is the person without insurance, who is stuck with what can be a very inflated invoice.
Of course, there are manifold problems with this industry; but until patients are exposed to accurate financial comparisons, the costs will continue to escalate.
> Dr. Smith said federal Medicare regulation would not allow for their online price menu.<p>> They have avoided government regulation and control in that area by choosing not to accept Medicaid or Medicare payments.<p>Obama, better close up that loophole! Wouldn't want people to find out that capitalism works in every. single. industry.
I really like their footer section :)<p>"FREE MARKET-LOVING, PRICE-DISPLAYING, STATE-OF-THE-ART, AAAHC ACCREDITED, DOCTOR OWNED, MULTISPECIALTY SURGICAL FACILITY IN CENTRAL OK."<p>[Edit]: The footer of the hospital in the article: <a href="http://www.surgerycenterok.com/" rel="nofollow">http://www.surgerycenterok.com/</a>
Can you call transparent pricing a "revolution" when the status quo is purposefully obfuscated and archaic in order to nickle and dime you? It seems more like just doing the right thing.
I don't know if other states do this, but at least in California hospitals report their prices (known as a chargemaster or master charge description file) online at OSHPD (<a href="http://www.oshpd.ca.gov/chargemaster/" rel="nofollow">http://www.oshpd.ca.gov/chargemaster/</a>). Even looking through these you'd be surprised what prices there are.<p>This isn't a new controversy, but still quite problematic - for some fun try Googling "usual, customary and reasonable" (UCR charges).
Some other techniques off the top of my head:<p>-- offer a "price match guarantee" against any procedures versus in-network hospitals<p>-- offer a discount for low-risk patients (non-diabetic non-obese) who need to have surgery done<p>-- do "bundle deals" with local hotels and/or attractions like they do with plane flights, so if you are travelling to the hospital you would have something for the family to do<p>-- free 1-month nurse concierge where you can call a hotline to followup after any procedure (would be great for baby deliveries)<p>-- discount on 3-months of physical training, along with a bundle deal at a local gym<p>-- offer a "retainer" that would lockin a price of any procedure for 5 years. Good for those who are family planning or have a low-priority surgery<p>It just seems like there's a market for something-that-doesn't-suck in healthcare.
Their price for a procedure I had in 2000, today, is half of what I paid out-of-pocket back then. Wow.<p>This is great, and I hope it's a sign of a trend.
While i know how health-care is working in the US, every time i read something about it i'm astonished and incredibly sad. How broke can a system be to put a price on health? And everybody cheering that someone is doing it in a trasparent way. Woooow. I wonder how you will all react if you'll find out, in future, that the surgery/procedure you actually need is too expensive for your pockets and not covere by the insurance (if you are elegible/have one).<p>Sorry to say this but: This whole system is a shame. And i just can't understand why the people in the US just don't realize it.
At hospitals in the US, every payer is charged a different price. Large insurers and HMO's negotiate large discounts which shifts costs onto smaller insurers who get smaller discounts and thus pay part of the costs of their larger competitors. The non-poor uninsured, who often can least afford to pay, are charged the most -- often 5X, 10X or more than what Medicare or a large insurer would pay. In all states other than Maryland, which has state-wide "all-payer" pricing, what you are charged depends more on who you are and how much negotiating power you have than what was done for you.<p>The solution is to let the "free market" work. Of course, that means we need to regulate the market to fix the existing "market failure." Free markets are regulated markets. (Although not all regulated markets are free.)<p>All states should pass laws saying that hospitals are free to charge what they want but that their prices must be posted and apply to "all-payers" without discounting. Additionally, states should develop all-payer databases like those advocated by: <a href="http://www.apcdcouncil.org/" rel="nofollow">http://www.apcdcouncil.org/</a><p>Much has been said about Medicare in the comments here that isn't quite accurate. The reality is that Medicare ignores hospital charges (except in Maryland) and pays according to their own calculations of hospitals' costs. In most cases, that means they pay much less than they are charged. However, in some cases, it means that they pay more.<p>For some additional background on this issue, from a New York perspective, see my PDF on the subject linked to at: <a href="http://bobwyman.blogspot.com/2013/04/RFC-FRAND.html" rel="nofollow">http://bobwyman.blogspot.com/2013/04/RFC-FRAND.html</a>
This article is a bit misleading. An outpatient surgery center has the luxury of "skimming" the easy uncomplicated same-day surgeries while leaving the hospitals to do the heavy lifting. It is <i>not</i> a hospital<p>Surgery centers do not have the cost of carry of a pharmacy(24/7), a fully functioning diagnostic lab(24/7), an emergency room(24/7), 200-1000 beds, ICU,CCU, radiology department(24/7) etc and an infrastructure that is impressively expensive.<p>Its very very very easy to offer these surgeries at a cheaper price than a hospital but when you need a complicated surgery or an emergency that surgery center <i>will not</i> be there for you.<p>I like the idea of pricing transparency but it should be hand in hand with outcome and quality statistics and comparisons should be fair.<p>I did not see Oklahoma surgery center compare themselves to other surgery centers which are likely very close in price.<p>One last thing. In healthcare - price is not everything (its an important issue) but as we drive down the price, we must not sacrifice but rather improve outcome measurement and quality.
When you think of upfront pricing it just makes sense. Recently someone posted a breakdown of their surgery here on HN (don't remember the kind of surgery it was, but it totalled about $30k), I don't understand how a hospital with the same medically trained staff as any other hospital (with exception of specialists of course which would vary) can be 4 times the price as this hospital is offerng to do it for and most likely the same level of care. I encourage everyone to read this Harvard Business Review article here which gives some insight into just how the American healtrh system runs: <a href="http://hbr.org/web/extras/insight-center/health-care/why-innovation-in-health-care-is-so-hard" rel="nofollow">http://hbr.org/web/extras/insight-center/health-care/why-inn...</a>
I can't really see how charging this much to ease people's suffering is humanly possible. Sure Surgery Center was a lot cheaper than the rest, but even that is still expensive. For example, if I want to gosurgery center and get an brain/heart surgery, I'd be looking at possibly $500 in overnight fees but not really anything else.<p>How is anyone inhumane enough to start a business like these hospitals? Any medical care should be available to everyone.
Breaking a finger shouldn't cost $2805 either. Countries like USA think they're superiour but yet they do not help their fellow citizens. If they would drop the war on the rest of the world(incl their own) they would probably afford to provide free medical care as well.
So, I've had this idea for a while and I'm wondering why no one has done it yet:<p>An Expedia for health care services.<p>You pop in your zip code, the service you need (if you know it), and out comes a list of hospital and doctors with prices for that particular service.<p>I imagine you could start very simple: call 50-100 clinics and ask how much they would charge for a simple checkup, upload it, see how many people start booking doctor visits via your site.<p>Check out Zoomcare:<p><a href="http://www.zoomcare.com/info/services-prices" rel="nofollow">http://www.zoomcare.com/info/services-prices</a><p>I went there in Portland and service was great! I loved the transparency. I just wonder why more independent clinics aren't trying this.<p>Is there some major legal obstacle I'm not seeing?
Similarly, at least to me, Birthing Centers are offering a much lower cost alternative to the whole delivery process at hospitals. From experience, the price difference can be 10:1 which is just insane. 10 being what is billed to insurance, 1 what you'd pay directly. Still, comparing apples to apples, it's 3:1. Again, from recent experience.<p>Bottom line, hospitals are big business and they can get away with billing insurance for a ton... and many times the extra "care" is unnecessary.
Healthy people can work and be productive.<p>When progressive startups say things like "We want you to work, and not worry about your income, so we're trying to pay you a salary that allows you to do just that" we all respect that, right?<p>Why can we not do the same with healthcare and just say its "free" (aka paid by our pseudo-employer - the Government) so we can all be productive and contribute to making the country/world a better place. Plain and simple...
Their pricing site should drop all the ".00" cents figures... it seems unnecessary and subconsciously makes the numbers look bigger than they are.
Price transparency is a key part of Obamacare and is apparently beginning to work. For example, insurance companies in Oregon reduced premiums after seeing competitor prices [1].<p>1: <a href="http://www.oregonlive.com/health/index.ssf/2013/05/two_oregon_insurers_reconsider.html" rel="nofollow">http://www.oregonlive.com/health/index.ssf/2013/05/two_orego...</a>
Not a hospital, but I patronize this medical group partially because they have a list of cash prices posted online<p><a href="http://www.caduceusmedicalgroup.com/cash-prices/cash-prices.html" rel="nofollow">http://www.caduceusmedicalgroup.com/cash-prices/cash-prices....</a><p>Even though I never needed it, having insurance through my employer, it's the transparency that I liked.
"hospital" may be a misnomer - these may be private facilities set up to do high-volume "day surgeries" that don't require ICU's or CCU's that tertiary care hospitals provide. They aren't expected to offer the full suite of hospital services, i.e. emergency, trauma, in-house pharmacy, etc.
The great thing about this is that could enable me to be my own insurance company. If I know how much things cost, then I can budget appropriately and invest in an index fund to store my health fun. If bad things happen, then I'm covered. If they don't happen, then I get a boat.
FYI for all Florida patients, under the FL Patient Bill of Rights FL Statute 381.026(4)(c)(3): "A health care provider or a health care facility shall, upon request, furnish a patient, prior to provision of medical services, a reasonable estimate of charges for such services."
It's called medical tourism, and it's absolutely rife in Asia. <a href="http://en.wikipedia.org/wiki/Medical_tourism" rel="nofollow">http://en.wikipedia.org/wiki/Medical_tourism</a> (I guess Oklahoma is the new Mexico, or something.)
So...let's create a reverse auction platform for self-pay surgeries? Not at all sure what the regulatory issues would be around that, but seems like it would make sense especially when you add in time and availability of specialist surgeons on certain days.
It should be the law that they must provide the pricing online and via an API so that it can be easily collated and compared with every other hospital. Imagine the type of apps you could create with this information.
Oh man I want this to be the new norm <i>so bad</i>. The American health care system really needs to be shaken up. Republican dissent in Congress blocked that when Obama was championing it; perhaps the Republican's stated goal of a free market is going to be what affects the change. Where are the free market republicans supporting these practices? Why are they so upset about people coming to work in America but not the fact that hospitals are able to use the insurance system to gouge consumers?<p>The cited $30,000 surgery costing a fifth of that at the centre makes it well worth the effort to fly from out of state to get your operation on. The old system of charging whatever you can get away with because the patient doesn't have options needs to die a horrible death.
I don't care how transparent there pricing structure is. Letting Kevin Smith practice medicine at you is a bad idea. Chasing Amy was pretty good, tho.