Following federal requirements, Mid-Columbia Medical Center has posted on its website its standard pricing for everything from baby aspirin to ER visits to medical procedures.
With an eye to improving transparency and allowing cost comparisons, federal law required all hospitals to post their pricing on the internet by Jan. 1. MCMC posted its pricing before Christmas.
The resulting Excel spreadsheets, found on the hospital’s website at the “About MCMC/data” button, list over 7,700 prices in three categories: medicine, supplies and procedures.
But that is the cost before insurance, and 95 percent of Oregonians are insured, said Philip Schmidt, associate vice president of public affairs for the Oregon Association of Hospitals and Health Systems. Plus, there is charity care for the uninsured, he added.
“Essentially, no one pays those,” he said of hospital list prices.
Of the 4,000-plus medicines available at MCMC, the most expensive—for treating multiple sclerosis—is $74,850 before insurance, while everyday pills like baby aspirin and ibuprofen are just a penny apiece.
Oregon has already taken significant steps in price transparency, Schmidt said. In 2015, the state made public its information about what commercial insurers paid for the most common procedures at every hospital in the state.
At Oregonhospitalguide.org, which is run by the hospital association, consumers can compare insurance payments at a specific hospital to the state median price, or do side-by-side comparisons with other hospitals.
For example, insurers paid MCMC a median amount of $572 for an ultrasound, while the state median was $343. At Providence Hood River Memorial Hospital, the median was $451.
A median represents the point where half the observations are below and half the observations are above the stated amount, according to the hospital guide webpage.
The effort helped move Oregon’s grade on a national scorecard for price transparency from an “F” to a “B,” Schmidt said. He said “there’s about five states that are not failing, and we’re one of them.”
Even with this positive step, he said, “We’re still in a world where calling the hospital is best,” for price estimates.
MCMC Chief Financial Officer Dave Sturgeon seconded that notion. He said the most important piece of information on the hospital’s page about its standard pricing is the phone number to reach its cost estimation team. It’s 541-296-7500.
He said 80 percent of the hospital’s patients are on Medicare (for senior citizens) or Medicaid (for low income), and the allowed charges for their care are set by the federal government.
He said Medicare patients have a 20 percent copay, and they want to know what their out-of-pocket costs will be. “Often, it doesn’t relate to the charge list that you’re doing the story on,” he told a Chronicle reporter.
He said the price list is “not very helpful to the individual.”
Sturgeon said he felt publishing the price list was a “first step in the right direction. I’m a consumer as well as you are. Over time, more transparency is going to increase understanding and competition around price and quality.”
The Excel spreadsheets are searchable by keyword, but they also contain medical abbreviations and terms like “Berkley vacurette curved 9mm” ($4.37 before insurance) or “blade dual-cut sagittal saw” ($186.25 before insurance) that might not be meaningful to a lay person.
“It’s kind of gobbledygook to the average person,” said Bill Palmer, MCMC’s manager of the analyst group in the information systems department.
He doesn’t feel the price list is useful—not only because it’s pre-insurance prices, but because the cost of surgery, for example, is hard to predict. “There’s all kinds of variables,” such as how many screws, sutures or absorbent pads might be needed, he said.
The price lists show every type of imaging for every part of the body, and also list supplies including dozens of different types and sizes of screws, which are used in surgeries.
The medication price list includes 52 medicines with five-digit prices. On the other end of the spectrum are 47 medicines that cost less than 50 cents per pill.
Services include the per-minute cost of being in the recovery room ($17 before insurance), starting an IV ($53 before insurance), inserting a cardiac monitor ($17,070 before insurance) and having a pinworm exam ($36 before insurance).
It wasn’t a big task for the hospital to prepare the price list. Oregon Health & Science University hosts MCMC’s patient computer systems, and OHSU compiled the data for MCMC, Palmer said.
Hospital groups have expressed concerns that the new rule won’t help patients and will create perception problems for hospitals because the price lists are not reflective of what patients will actually pay, one online article noted.
Prior to this new rule, hospitals only had to make their price list available on request.
MCMC’s Palmer said, “We have people call up and ask for costs before they have procedures done. That’s definitely gone on for years, and we do the best we can to estimate it.”