Okla. Surgical Center Reveals Prices to Patients


Larger medical centers face other obstacles in making their prices public. Experts point out that prices for procedures and medication varies wildly depending on who is paying. Different insurance carriers can have negotiated certain prices for procedures, which can vary greatly, and the uninsured can be charged prices astronomically higher than those paid by private insurance carriers or Medicare. Additionally, since usually it is the insurance company that will cover the majority or all of the bill, the patient has less incentive to find out the price or argue for a lower one.

Health Insurance Costs Outpace Wage Gains

Medical centers with hundreds or thousands of employees also have much higher gross overhead costs than the relatively small Surgery Center of Oklahoma. They also have to treat all patients that are in need of care, whereas the Surgery Center of Oklahoma offers specialized care.

Katherine Hempstead, the senior program officer at the Robert Wood Johnson Foundation, said that transparent pricing may not affect many customers because their insurance will cover the price. Instead it could be more helpful for insurance companies to make clear what different medical centers will cost for each individual policy holder through their deductible or co-insurance payment.

"A lot of consumers don't necessarily care," said Hempstead. "Pretty much, they're not sensitive to price information."

Get Better Healthcare on the Web

Others worry that by providing price transparencies without also being transparent about the quality of care, patients could end up at medical centers that don't provide a good standard of care.

"In the absence of quality information, you shouldn't assume that cheaper is better or more expensive is better," said Rosenthal.

However, Rosenthal thinks by learning more about healthcare costs, patients can begin to demand more from both their insurance companies and their healthcare providers.

"[I want to] be careful of excessive early optimism," said Rosenthal. "[But] the conversation -- Why are we paying so much? -- is escalating, and that's important."

For Horner, the ability to price shop was key to staying out of debt and receiving appropriate care. More than six months after Horner's surgery to repair his knee, he is able to walk just as well as before his injury, and no medical bills are lurking in his mailbox.

"I've had a few surgeries in my life and it's always a guess [on the price] when all the bills showed up," said Horner."[With this surgery] I had no more additional costs. It was a huge relief to me."

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