Today’s post appears courtesy of one of my newest LinkedIn connections, Elizabeth Ziemba, CEO of Medical Tourism Training, who posted a link to a New York Times article today about the price for a new hip in one of my LinkedIn groups.
In the article entitled, Price for a New Hip? Many Hospitals are Stumped, by Elisabeth Rosenthal, a senior at Washington University in St. Louis, Jamie Rosenthal (no indication of relation), contacted more than 100 hospitals in every state last summer. Ms. Rosenthal was looking to get prices for a hip replacement for her grandmother who did not have insurance, but who could pay for the procedure herself. The grandmother was fictitious and part of a research project on health care costs.
What Ms. Rosenthal found was that about half of the hospitals she contacted were able to quote her a price. Those that did quoted prices in a range from $11,100 to $125,798. Her findings were released yesterday as the basis of a paper by JAMA Internal Medicine. It is likely to fan debate on the unsustainable growth of US health care costs and a medical system so opaque that prices are often hidden from health care consumers.
Dr. Peter Cram, an associate professor at the University of Iowa, who co-wrote the paper with Ms. Rosenthal, said that, “I can get the price for a car, for a can of oil, for a gallon of milk. But health care? That’s not so easy.”
Jeff Rice, the CEO of Healthcare Blue Book, stated, “We’ve been trying to help patients get good value, but it is really hard to get price commitments from hospitals – we see this all the time.” He went on to add, “And even if they say $20,000, it often turns out $40,000 or 60,000.”
The article points out that most patients or insurers never pay full price of surgery because insurance companies bargain with hospitals and doctors for discounted rates. However, the telephone quotations Ms. Rosenthal received underestimated prices because they did not include rehabilitation fees.
This would seem to be an obvious boon for the medical tourism industry to promote lower cost hip replacements at dozens of medical tourism destinations around the world, that charge a fraction of the cost US hospitals do, even at the “bargain basement prices” as the article mentions.
For workers’ compensation, in states that have or do not have fee schedules, this fluctuation in prices for hip replacements, means that even if they are charged lower rates, they cannot compare to rates available in hospitals in India, Singapore, Thailand, Mexico, Costa Rica, etc., as I have repeatedly blogged about and written about in my posts and White Paper on implementing medical tourism into workers’ compensation.
Until we bring health care costs under control, and the likelihood of that happening under ACA is doubtful, medical tourism offers the best alternative to “the sky’s the limit” health care prices for hip replacement and many other procedures common to workers’ comp. Not exploring this option, with the added benefit of no cultural or linguistic barriers for workers from Latin America and the Caribbean, including airfare and accommodation costs for spouses or companions, and the self-esteem one would gain from receiving treatment at a world-class hospital in their home countries, is a mistake employers and carriers should not make. Even if workers are not connected to these destination countries, the fact that they are located in resort locations, will enable them to recover faster, have a better overall health care experience, and may even help speed their return to work, something that most employers and carriers would appreciate.
For a description on how to build outpatient case rates, I refer you to the following White Paper from my connection, Maria Todd: http://axiomhealthgroup.com/images/pdfs/caserateswp.pdf