Zurik: Nothing clear about health costs at some local hospitals

ANGIE, LA (WVUE) - Experts say the only way to save yourself money when it comes to healthcare costs is for providers to actually tell you their costs. But some local hospitals refuse to hand over that information - and some of those hospitals are owned by you, the taxpayer.

We pulled out some office supplies to help tell this investigative story: a red pen, a highlighter and a calendar.

It all has to do with hospitals trying to hide information about how much it costs you for a visit.

Maria Magee can sum up her feelings about that practice with a single word:

"Angry," she tells us. "You don't go to Walmart and pick up stuff without a price knowledge."

A short gravel road leads to Magee's house in Angie, north of Bogalusa in Washington Parish. Magee gives her insurance company and her hospital a bad grade for a nearly $800 echocardiogram bill.

"My part was $776, [of] which my insurance paid basically nothing," she tells us. "And they said they would apply it to my deductible."

Magee has Cigna insurance and had the procedure at Louisiana Heart Hospital. She could have saved money by ignoring her insurance plan and paying cash.

"Had they not even used my insurance, my part would have been $400-plus, maybe," she says. "So, I would have had almost half to pay, instead of the privilege of using my insurance."

Those cash prices can be important. But some providers don't want you to know what they are.

FOX 8 News and our partners at NOLA.com | The Times-Picayune and ClearHealthCosts.com asked every hospital in the area to share their cash prices for 35 procedures, such as MRI's, mammograms and colonoscopies.

Four hospital groups refused to hand over that information: HCA (which operates Tulane medical center), East Jefferson, Terrebonne General and Slidell Memorial.

"It's saying that they're playing a game with us and that what they're not doing is looking out for the patients," says healthcare policy expert Robert Field. "What they're looking out for is purely the bottom line."

Some hospitals simply dodged our questions. Consider this example:

• Thursday, April 13, we sent Terrebonne General Hospital an email, asking them to fill out a form that lists their prices on different procedures;
• Five days later, April 18, we received an email from Terrebonne, requesting an "extension" to allow them "adequate" time to provide the information;
• April 27, we receive another email - it took two weeks to gather a three-paragraph response. And nowhere in the response do they address the pricing information we requested - they simply ignored it and didn't provide it.

"To play this game with life-or-death services, that's just not the way the system should work," Field says.

In addition to the pricing information, we asked each hospital four questions.  One day after our April 18 deadline for responses, East Jefferson Hospital replied: They ignored our questions and ignored our pricing request.

"I think any hospital should be very up front about what the cost is," says Jefferson Parish Council Chairman Chris Roberts.

East Jefferson is a public hospital, essentially owned by Jefferson Parish taxpayers.

"I know that there have been a number of challenges particularly for many hospitals around," Roberts says. "And a lot of times, when you can look at it and ask those questions, they say, 'It's about competition.' Well, the thing is, if your competitors are giving this information out, what precludes you from doing the same thing."

And many competitors did give us their pricing information. Ochsner provided it for every facility; so did LCMC, which runs West Jefferson Hospital, Touro, University Medical Center, Children's Hospital and the New Orleans East hospital. North Oaks in Hammond and Thibodaux Regional Medical Center also provided pricing data.

"Seeing the actual cash prices that other vendors, other merchants, other hospitals are willing to accept lets us see who is doing a good job at a fair price," patients' advocate Dave deBronkart tells us. "And that's what America needs in healthcare."

Field says insurance prices are mostly cheaper than what's available by cash. Still, he says, the true cash prices are revealing.

"Every healthcare provider has sort of their rack rates, the way a hotel would," he says. "Most people don't pay those rack rates, they pay the Travelocity rates or the discount rates for their discount club or whatever. But there are those rack rates in the background.  Those rates do correspond to what people actually pay.  So, if the basic cash price is higher, than the discount price is also going to be higher."

These cash prices unmask significant findings about hospitals and clinics pricing.  A routine blood test at University Medical Center costs $370.  At Tulane Medical Center the cost is lower, $287; at Ochsner, it's a fraction of the price, $48.

Another example: an abdominal ultrasound can range from $971 at Thibodaux Regional Medical Center to $312 at West Jeff, or as low as $170 at Ochsner in Kenner.

"If you want to get to bottom of what's really going on," deBronkart suggests, "if you're sort of a detective, right? Something's going dreadfully wrong here... The cash price shows you the real transition value."

But some hospitals refused to hand over that critical information.  HCA wrote that their patients "should call and discuss" with a "representative", and there are "too many variables" to make "broad estimates... Meaningful."

HCA's statement fails, though, to explain why other hospitals do share pricing, and it doesn't explain the variables encountered for a simple procedure like an MRI or blood test.

"Think of going into a department store and looking for a TV," Field suggests. "You're going to see dozens of them on the wall. First thing you're going to do is see what image you like; next thing anyone's going to do, you're going to look below it to see what the price is. And then you can decide, can I afford the high-end TV? What is the ratio for me of the benefit of this better image against the cost.  Well, healthcare, we don't even know what we're buying.  We don't know which is the better MRI, the better X-ray. We don't even know if we need it."

Maria Magee had no idea how much her procedure would cost.

"They insulted me with, 'You could have called and asked the price before you had it done,' she tells us. "'You could have called the insurance and asked the price.'

"Well, you're not thinking of all this when the doctor's ordering all these tests.  And you found it out in hindsight and it does you no good - you got it, now."

Magee says it's important to highlight the hospitals that did provide information, but circle with a red mark the ones who remain secretive.

"I think they hold that back to be able to make more profit," Magee says.

She couldn't afford that pricey trip to the hospital.  We pulled out our calendar again: It's taking her about 16 months to pay off that routine procedure that would have had her bank account in the red.

"I can't imagine elderly people coping with all these phone calls and keeping up with everything," Magee tells us. "To me, it should be offered up along with the prescription for the test."

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Remember: we want you to join our Cracking the Code investigation. Please contribute your prices, your stories to our database.

• Go online to fox8live.com/health
• email us at health@fox8live.com
• or call us at 504-483-1558.

We want to see the prices you have to pay on any procedure. 

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