Skip to main contentQuick: How much does it cost to have your appendix removed? Take a wild guess. $1,500? $5,000? $15,000?
If you have no idea, you're like most Oregonians. While consumers can get a car-insurance quote in five minutes, they have no way of finding out what a medical procedure will cost before the doctor unsheathes the scalpel.
Now some of Oregon's biggest health-care purchasers, including the City of Portland, State of Oregon and SAIF Corporation, are trying to collect cost and quality information from local hospitals and make it available to the public--a plan the hospitals would just as soon see die on the table.
Last year, the Oregon Coalition of Health Care Purchasers persuaded eight health-insurance plans to reveal the price they paid hospitals for 14 common procedures, from coronary artery bypass surgeries to Caesarean sections. Coalition chair Pam Bybee says she wanted to release this cost information to consumers alongside statistics about each hospital's success and mortality rates.
"If you knew you were going to have a surgery...and there was a tool on the Internet to tell you quality and cost information at different hospitals, then you could make a good choice for yourself," says Bybee. "Right now, you can't get any information at all."
To test this, WW contacted three hospitals to get a price for a standard vaginal hysterectomy with a three-night stay and no complications. At Legacy Emanuel, hysterectomy patients pay an average of $11,100, while the average Oregon Health & Science University patient pays $15,307--nearly 40 percent more. (Providence Health System spokesman Gary Walker told WW, "Providence is not interested in taking part in this story.")
But average prices can be deceptive. Hospitals typically charge different rates for different patients, depending on what kind of deal the hospital has cut with the patient's insurance company.
Once hospitals got wind that the Coalition's study would reveal their pay arrangements with insurers, they quickly brought the hammer down.
"What we had to do is remind insurance companies that they had confidentiality agreements," says Ken Rutledge, president of the Oregon Association of Hospitals and Health Systems. "We had to use a heavy hand there."
Rutledge claims the reality about prices is more complicated. Some hospitals provide more comprehensive care than others, while others provide more charity care to the poor (which hikes the cost for everyone else).
The real problem, he says, is rising costs; according to Mercer Human Resource Consulting, employers' annuals costs for providing health insurance jumped 10 percent nationally in 2003 (from $5,646 to $6,215 per employee) and are expected to zoom up another 13 percent this year.
But Bruce Goldberg, head of Oregon's Office for Health Policy & Research, says the opacity of health-care costs is an integral part of that problem.
"Until costs are explicit, they will continue to go up," Goldberg says. "Not only can we not afford health care, but we don't even know what we're paying for."
For now, the hospitals' opposition has knocked the Coalition's study cold, but Bybee says she'll lobby legislators to force hospitals to reveal their prices.
"This is an important topic," Bybee says. "We aren't going away and we aren't going to give up."
WWeek 2015