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Managing Geriatric Care Hospital Sticker Shock

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managinghospitalstickerDo you know how much a pacemaker costs…fully installed?  Well, if you or a loved one have no heart condition that would require a pacemaker, it may not mean much to you, but how about the cost of a hospitalization to treat your loved one’s pneumonia?  That is definitely on the radar of geriatric care consultants and most caregivers with an elder parent or loved one under their care.  And by the way, the answer to both questions is the same: what you spend for care depends on where you go for the hospital stay.

The fact is, however, that now you can actually begin to compare the prices for 100 of the most common medical procedures performed in about 3,300 hospitals across the country who accept Medicare reimbursement.  The published prices are now available to the public under one of the many reform provisions of the Affordable Care Act (ACA), referred to by some as ObamaCare.  The reason that these prices are now going to be made public is because “sunshine” is now being shed on the many factors that have made the “health care marketplace” far from an actual market in which consumers can make decisions based upon having all the information that should be available in a free market.  The sticker prices are now available.

For instance, go to Vista Medical Center East in Waukegan for that pacemaker and the sticker price will be $165,000.  Travel 30 miles to Centegra Hospital in McHenry, and you will see a bargain price of only $36,000.  Go to  Loyola Gottleib Memorial in Melrose Park with pneumonia, and your bill will be about $32,000.  Yet, go to Stroger Hospital, and a simple case of pneumonia will be treated for $7,674.  There is one hospital in Dallas that will charge over $38,000 for the same pneumonia case, and another not far away in Texas will change only $14,610.  You may not pay the same prices, because your insurer (e.g., Medicare) will have negotiated a lower rate, so you will want to do your homework on that.

For those who are concerned about differences in quality of care that area associated with the price differences, data on quality of outcomes also will be available for these hospitals.  One of those “quality measures” will include the number of people who are readmitted to the hospital for the same condition within 30 days of their discharge.  In fact, the ACA will begin penalizing hospitals if their rates of readmissions are above the national average beginning in October of this year.  Check out these web sites in Illinois: hospitalcompare.hhs.gov  and healthcarereportcard.illinois.gov.

Charlotte Bishop is a geriatric care consultants and founder of Creative Case Management, certified professionals who are geriatric advocates, resources, counselors and friends to older adults and their families in metropolitan Chicago.  Please email your questions to ccbishop@creativecasemanagement.com.

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