With the rising cost of health care, Medicaid Filing Services, LLC, Clearwater, FL, helps seniors to qualify for the Medicaid coverage they need. Their focus is on long-term care and crisis Medicaid planning, helping clients to determine their eligibility and receive benefits. Not all facilities charge the same fees, however, as a recent article in The Miami Herald points out. As more organizations are releasing their costs, the discrepancy becomes more evident.
Last month, the Centers for Medicare and Medicaid Services released the prices for 30 outpatient procedures. This information allowed the public to see the difference in prices billed by hospitals for the same services. For example, at Aventura Hospital and Medical Center in Northeast Miami-Dade, it cost an average of $5,526.12 for a Level 2 excision and biopsy. At Holy Cross Hospital in Fort Lauderdale, the same procedure cost an average of $7,310.79. That is a difference of $1,784.67. And yet at Broward General Medical Center in Fort Lauderdale, it only cost an average of $2,168.17. The national average for the procedure is $2,768.18.
Depending on where patients go for treatment, they are charged very different prices. The Obama administration hopes that making these costs public will “increase transparency from healthcare providers and empower consumers to be smarter shoppers for medical care.” By having more data available for comparison, consumers can make more informed decisions regarding care for themselves and their family.
Not everyone welcomed the sharing of information with the same sentiment. While he feels that the release is “yet another step forward in transparency,” president of the American Hospital Association Rich Umbdenstock also “urged that greater attention be given to the payments hospitals receive from Medicare and private insurers.” He notes that “Medicare currently pays only 89 cents for every dollar hospitals spend treating outpatient beneficiaries.” And the costs that hospitals charge are not necessarily what patients are paying out of pocket.
When consumers invest in private health care, they are often only paying a portion of a pre-negotiated rate for service. They also must typically use a provider pre-determined for them by their insurance. Understanding out-of-pocket expenses is what consumers really need to know according to Chip Kahn, president of the Federation of American Hospitals. Knowing the cost of what the hospital charges is not always beneficial because it does reflect the cost to patients. He believes that “insurers should be required to provide to their members meaningful cost-sharing information enabling them to make good healthcare choices.”
Hospital prices and Medicare payment rates are what insurance companies use to determine reimbursement rates, however. As more providers are shifting from co-pays to co-insurance, it could change the cost to consumers. Whereas co-payments are fixed rates that consumers pay, co-insurance requires them to pay a certain percentage of the cost for procedures instead. Since prices vary greatly between hospitals, so will the price to patients and providers.
Take for example the charges billed to Medicaid. It cost approximately $4,984.50 for an MRI at the University of Miami Hospital, when just across the street, Jackson Health System only charged $2,919.08. And yet in Broward County, the costs were even different still. Memorial Regional Hospital in Hollywood charged an average of $4,860.22, while Broward General in Fort Lauderdale charged $3,146.27. The national average for an MRI is approximately $2,587.59. Those are some significant differences in cost. And yet Medicaid only paid about $350 to each hospital for an MRI.
Releasing hospital costs becomes more beneficial to privately-insured consumers as coverage trends toward high deductible plans. This requires patients to pay a pre-agreed amount out of pocket before insurance begins to pay a percentage. More consumers could start comparing costs before they make their decisions since they are responsible for the initial payments.
Not all hospitals are as reluctant as others to publish their prices, however. The recent release of information has actually motivated one hospital executive. Steve Sonenreich is the Chief Executive of Mount Sinai Medical Center in Miami Beach. In May he made a public pledge “to divulge the contractual rates the hospital charges private insurers for diagnosis and treatments.” He believes that this transparency will result in lower healthcare costs. He also accused some hospitals of “driving up costs by leveraging their market position to extract higher fees from private health insurers,” which he says will “force private insurers to negotiate lower rates of payment with other hospitals for the same procedure.”
The data release by the Centers for Medicare and Medicaid Services revealed that Louisiana, Florida, and Texas ranked the highest in the nation as far as total cost per Medicare beneficiary, while Hawaii ranked the lowest. In 2011, the average total per capita in Louisiana was $11,088, while in Hawaii it was only $5,564 per capita. The national average for 2011 was $9,003.
Medicaid Filing Services, LLC, Clearwater, FL, supports the release of cost information to the public. “Any time the public knows more information pertaining to the cost of health care, I feel it is beneficial,” reports a spokesperson for the company. “By having the ability to compare hospital rates for hospitalization and procedures, the consumer can actually make an informed decision as to where he or she would prefer to go for treatment. By having large deductibles, knowing the true costs associated with hospitalization and services ahead of time can really make a difference when paying the out-of-pocket deductible, or, of course, self paying.” The staff at Medicaid Filing Services, LLC, Clearwater, FL, help clients to understand the eligibility guidelines and costs associated with Medicaid coverage in Florida, leading to more informed decision making.
Medicaid Filing Services, LLC, Clearwater, FL, is a company dedicated to providing clients with complete information, satisfaction, and protection when filing for Medicaid. Experienced professionals help residents to preserve their assets and meet eligibility requirements for Medicaid coverage when entering long-term care. The company also provides Florida residents with free access to advanced directive forms, saving them time and money. They can download forms regarding Power of Attorney, Living Wills, and Health Care Surrogates.