Zurik: Tulane Health chief slams ‘Cracking the Code’

NEW ORLEANS (WVUE) - Lexie Montgomery didn't mind paying a $40 copay for a routine doctor's office visit. But she doesn't like the sticker shock of the surprise bill she received in January.

That $40 visit now costs her $114.

"The office visit had gone from $90 a visit to $272 a visit," she says. "And my patient responsibility is now $114 for office visit, which is more than what the office visit was in October."

Montgomery's insured by Blue Cross Blue Shield. Looking at her bill, it's unclear if her increase is because of her insurance company or Tulane Multispecialty Clinic.

"I can't think of another service that you go in, thinking you're paying a certain price, you get the service done, and then you go to pay and it's triple the price," she says. "It's like Russian roulette - you just don't know what it's going to be."

For the past month, FOX 8 News and our partners at NOLA.com | The Times-Picayune and ClearHealthCosts.com have tried to bring transparency to healthcare pricing in the metro area.

Tulane Medical Center president and CEO William Lunn distributed an email to his medical staff about our story, writing, "We are extremely disappointed in the tone and intent of these stories. Despite the media's claims, they have not been developed with an interest in explaining the healthcare process or helping consumers understand their care."

FOX 8 and our partners developed our stories to bring transparency to healthcare pricing in the metro area, or at least give patients questions to ask before they schedule a visit or procedure.

The Tulane email added that our stories "were developed in a continuing theme of painting healthcare providers as greedy and opportunistic, with our patients as unwitting victims."

Tulane Medical Center is owned by HCA Healthcare, a for-profit company.

The email goes on to say, "Absent in these stories is any responsibility on the part of health insurance companies - which have much more say in what a patient actually pays than do providers - or employers who are continuing to shift employees to high-deductible plans."

Some of our stories have mentioned insurance companies. Our future reporting may address some of these issues, and we have asked Tulane's William Lunn for an interview to discuss them.

"Obviously, insurance companies are... not going to be in it if they can't make a profit," says Loyola president Kevin Wildes, who specializes in medical ethics and health policy.

Wildes has consulted hospitals on how to stay in business while also, as he puts it, keeping their integrity.

"You have to stay in business," he says. "But you have to know, how can you stay in business without sacrificing what your mission is?"

He has also consulted with the state Department of Health. Wildes uses a chart in class that shows how much healthcare costs have skyrocketed.

"They're growing far more than the national GDP," Wildes tells us. "They are the largest single growing area of American life."

And he says doctors aren't necessarily the ones making more money. "Professionals are making a lot less than they used to make... Doctors but also nurses, other people. I think that there is a lot of waste in the system. There's a lot of waste."

Most shocking to many of our viewers has been how prices can vary so much on the same procedure. "Not only do prices vary from Hospital or Clinic A to Hospital B," Wildes notes. "They may even vary within the hospital."

For example, look at Ochsner's cash prices on procedures throughout the metro area. A lower back MRI costs $825 on the North Shore, $540 on the main campus and $535 in Kenner.

Several providers have voluntarily shared all of their pricing data with us. And that data has helped many of our viewers.

Debi wrote, "Thank you Fox 8 for doing the research on this. It's very helpful to me and many others. We have started asking the right questions now and have saved hundreds already."

Another viewer had an MRI scheduled at Tulane Medical Center. The cost: $4,458 . She went onto our online tool and found it cheaper at another clinic, and saved $3,786 .

Another viewer wrote, because of our series, she "actually found a mistake on my bill. I was coded for an expensive procedure I did not get. The only reason I found the error was because I was trying to enter the information into the online tool."

"I just paid off the bill last week," Montgomery tells us. "And I'm sort of in aftershock... I feel very uneasy about going back to the doctor."

Montgomery says healthcare providers and insurance companies need to be more transparent about costs. "I'm glad that you're doing this because I'd like to know... who's charging what?" she says.

Providers have voluntarily contributed prices to our interactive tool. They're sending it to us unsolicited.  Many others have answered our emails and contributed to our online database that now has more than 3,100 different prices.

Viewers continue to contribute, too, handing more ammunition over to patients who are trying to crack the code on rising healthcare costs.

In response to our story, Tulane Medical Center and its owner, HCA, wrote, "The amount patients are asked to pay for hospital services typically is determined by the insurance coverage they have. If patients have questions about their deductible or co-pay, they should review their plan with their insurance company."

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You can read NOLA.com's Cracking the Code coverage here.

And remember: we want you to join our 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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