St. Joseph's reveals costs for services
With a move to a stronger consumer-driven society, patients want to know not only what a hospital procedure or service cost, but also what portion of the service their insurance may cover.
To meet this expectation, St. Joseph's Area Health Services, and its parent organization, Catholic Health Initiatives, are moving forward with a national initiative to introduce a new service for patients. Other healthcare facilities from across the country are calling this service "pricing transparency," a practice in which hospital service prices can be better understood by consumers.
St. Joseph's Web site now lists the median cost information for more than 700 inpatient and outpatient procedures through a program called, "Understanding Hospital Prices." (Median is defined as the midpoint in a list of charges over one year's time - half of all charges are higher and half are lower.)
While the prices reflected in "Understanding Hospital Prices" do not take patients' insurance coverage into consideration, St. Joseph's is encouraging patients to contact the hospital's financial counselors to help determine insurance coverage and to provide a cost estimate based on individual insurance. By using an estimator tool, the financial counselors can provide patients with accurate estimates based on procedure costs and the patient's insurance information. They'll also have the opportunity to share information about programs and payment options much earlier with patients.
"For scheduled care, we are now able to reach out to patients before their hospitalization and help them understand their responsibility for the cost of their care," notes St. Joseph's Chief Financial Officer, Brent Schmidt. "The goal of the program is to help patients better understand what their out-of-pocket expenses will be, so they can plan accordingly."
The primary advantage to St. Joseph's is that receiving payment at the time of service helps avoid additional administrative costs, saving the patient and community money. For the patient, it means they will know the cost of a procedure up front, what their insurance will pay and what their out of pocket balance will be. Collection of self-pay balances at the time of service is becoming more common among hospitals as payments from Medicare, Medical Assistance, and other insures continue to tighten, more patients are uninsured or carry high-deductible plans, and extending credit without interest charges pushes hospital bills toward the bottom of the list for payment.
"We understand that this is a big change for our patients so we plan to move slowly in this area," says Ben Koppelman, St. Joseph's President/CEO. "We hope that by providing more information to patients up front so that they are aware of what their out-of-pocket expenses will be, not to mention sharing payment options and programs with patients early will be of benefit to both of us," Koppelman adds. "No one will be denied health care services based on their inability to pay. Our goal is to help patients become better educated about health care prices as we continue to work to improve access to health care in our community. "
Asking for patients to pay their portion of the bill at the time of service is something that many hospitals historically have not done, but Koppelman says that is changing. "It's a sign of the economic times and what health care organizations are having to do remain viable."