By: Erin Miller December 05, 2022 December 15, 2022
Source: WTKR
Photo / Image Source: Unsplash,
CHESAPEAKE, Va. — Everyday, people across the country are forced to choose between physical pain and financial pain.
Christine Hanna, from Virginia, makes about $25,000 a year. She works in retail and her husband is on disability, so she said every dollar counts.
After an injury, she was on the fence about getting physical therapy. Hanna said after learning it would be about $90, she agreed to treatment.
However, the final bill was more than 10 times that amount. "$1,000 is not something I would handle. If they had told me that, I would have said, 'I'm not even going to try rehab,'" Hanna said. "We can't afford that. Not at all. We're definitely like poverty level."
It's because of stories like Hanna's the federal government has made changes. Hospitals are now required, and they have been since 2021, to post the cost of their services. "We worked with a third party to make sure that we were compliant," said Timothy Garrett, Director of Payer Contracting at Chesapeake Regional Medical Center.
The Hospital Price Transparency Rule requires hospitals to list their prices in two ways:
With a machine-readable file, like an excel spreadsheet, that lists all of the hospital's charges and negotiated insurance rates
With a program that's easy for consumers to use and understand
News 3 anchor Erin Miller wanted to see what changes local hospitals have made, so she reached out to each of them.
Bon Secours wasn't available for an interview regarding price transparency. However, they sent a statement to News 3: "Bon Secours believes in price transparency and empowering consumers to know more about the cost of their care. Because health care is complex, we will work closely with patients and their families to provide information about the payment for their care, what their insurance covers and ultimately what their out-of-pocket expense may be.We encourage patients to call 1-855-838-4604, Mon - Fri, 8 a.m.-6 p.m. to discuss their individual situation so they can obtain an estimate based on their individual payor guidelines. Our teams are ready to help patients and their families understand the cost of their care and resources available to them, at any time during the treatment process. Our Mission is to improve the health of our communities and to care for all in need, regardless of ability to pay."
Bon Secours Chesapeake Regional Healthcare created a price estimator tool. "We have different options available for the patient to select and it will produce an estimate of potential costs. The key word here is estimate," said Sonya Meade-Settles, Director of Patient Access. An estimate, Meade-Settles said, because service, health plan coverage and deductibles all play a role.
"If a patient goes to see a doctor, say, three weeks before, and that claim goes to the insurance, and they have an out-of-pocket deductible. Well, if that claim has not been posted, that potential estimate could be a little bit off," she said, as an example.
Follow these steps to view a cost estimate on a medical service offered by Chesapeake Regional:
Go to ChesapeakeRegional.com
Click on "Bill Estimator"
Select whether you have insurance, do not have insurance, or if you're seeking a cosmetic procedure
Select from the categories to see a list of available services
After you select a category, choose the service to obtain your cost estimate
Enter the code shown at the bottom of the screen
View your cost estimate
For an example, Erin Miller chose an X-Ray from the list. After entering the information, an estimate of $495.53 was populated.
"Our focus is on educating the patient and providing available resources," said Meade-Settles. "We are a community hospital." The Hospital Price Transparency Rule lets consumers take Chesapeake Regional's price and compare it to other hospitals. While the idea is to create competition and potentially lower prices, healthcare is still expensive.
"I get emotional about it. It's a crime," said Dr. Keith Berger. "This was a first step." Dr. Keith Berger is a gastroenterologist and has treated patients in local hospitals over the years. He's also the CEO of the Center for Health and Cancer Prevention.
"If you didn't know, it was gonna cost you say, you know, whatever it $4,000 at a hospital versus $400 in an office, how would you know to even ask the question?" he said. "My daughter was in [the hospital] with my grandson [and it cost them $1,800 for an hour] and she has 'good insurance.' Saying that, I'll bet you anybody watching this interview has had an experience like that."
Dr. Berger said he wants more people to feel empowered to ask questions about their healthcare. In fact, he testified before the General Assembly in Richmond pushing for a transparency law in Viginia. It was passed and goes into effect July 1, 2023. "That was a step forward because with the state law, in addition to the federal rule, they felt like there was more that could be enforced," said Dr. Berger.
He said within the hospital system and private practice, education is key to change. Dr. Berger said, in some cases, his office is able to provide colonoscopy procedures for free. He said he absorbs the cost of the procedure whereas a hospital has more overhead.
"If you don't know something you can take advantage of, you can't be prepared for it," Dr. Berger said.
If people are concerned about the cost of treatment, Chesapeake Regional has a financial assistance team to help patients.
"They can screen the patient to see if they're eligible for our financial assistance program. We have financial assistance for different types of drugs, we have an infusion suite," said Meade-Settles. Thursday morning on News 3, Erin Miller will share the reports that evaluate a hospital's compliance and the penalties institutions can face if they aren't abiding by federal guidelines. She'll sit down with advocates and Sentara Healthcare.
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