WILMINGTON, NC (WECT) - Knowing the price before paying seems like an obvious concept, but until 2019, hospitals didn’t have to tell patients up front how much a procedure costs.
The Inpatient Prospective Patient System Rule gives patients more information than they had before with a goal to “stop surprise billing by providers."
However, prices listed online are sticker prices without insurance or deductibles factored in.
Hospitals in the Cape Fear area list what are called the "average” prices for procedures. That’s not what most patients pay, and doesn’t include any financial assistance.
Leaders at New Hanover Regional Medical Center started a price transparency team to educate patients on what goes into costs to make sure the sticker price won’t scare them off.
“We would never want anyone to forego medical care because they’re worried about the pricing," Diane Alburn, vice president of revenue cycle at NHRMC, said. “It is important for price transparency and for patients to have that information. We just want to make sure it doesn’t prohibit them from getting the care they need.”
NHRMC has financial counselors and assistants to help patients, and plans to launch a program for doctors to pull up prices of prescriptions in the office for patients so they can choose what medications work best for their budgets.
”I think the more information we can put out there the better and the more information we can provide to the patients to educate them into what goes into the costs of healthcare," Alburn said. "It’s unfortunately very complex, as everybody knows, and a lot of folks don’t understand it so the more we can provide and put out there with the charges the price estimates, our discount policy, our financial assistance, having folks available to walk through that and educate them, I think the better off everyone is going to be.”
The hospital also offers a 50 percent discount for anyone who is uninsured.
Other hospitals in the area also have employees who will help break down the prices with insurance and other financial help factored in, and the names of those procedures.
The names are hard to understand without a medical degree. Patient advocate Dr. Sheila Hume of Medifriend Advocate said don’t be afraid to ask doctors to explain those technical terms.
She also said patients should do their research because health isn’t something to take lightly.
“Consumers are demanding it. We want to know," Hume said. "We won’t go into a store and pick up an item and go to the cash register with no idea what we’re going to have to pay for it until they’ve rung it up and then go, ‘This is what you have to give us now.’ You aren’t going to do that. We’ve had to do that with the medical field.”
According to Hume, this is a first step in cutting health costs, not a solution. She said to look at hospital safety scores and compare and negotiate prices between hospitals. Asking a patient advocate for help understanding the information can be beneficial as well, she added.
Ellen Abisch, president of Health Advocate Services, agreed that this is not a permanent solution.
"For the patient who wants to know the information, it’s good to put in their toolbox, but it’s only a small part of what they need to be good healthcare consumers,” Abisch said.
Columbus Regional Medical Center has a customer service number for help learning about the new regulation. Call 910-642-1744.
Dosher Memorial’s number is 910-457-3810.