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New website offers guide to hospital pricing

First Posted: 10:35 am - July 22nd, 2015

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NEWBERRY — A new website introduced this week by the S.C. Hospital Association is designed to help consumers better understand hospital pricing by allowing them to access information about services and charges at hospitals across the state.

South Carolina PricePoint (www.SCPricePoint.org) advises insured patients to talk with their insurance companies up front to find out what their out-of-pocket costs will be. What patients ultimately pay will depend on whether they have insurance, as well as the type of coverage.

Private insurers negotiate discounts with some providers, and government programs, such as Medicare and Medicaid, mandate hospital reimbursement payment rates.

“Nothing is more frustrating than sticker-shock when you make an important purchase,” said Thornton Kirby, CEO of the SCHA. “Our hospitals work every day to improve the health of South Carolina citizens and we are determined to address, truthfully and candidly, the growing concern of hospital pricing in our state.”

Bill Manson, chairman of the SCHA board and CEO of AnMed Health in Anderson, said this was a starting point for price transparency in South Carolina.

“Our state’s hospitals put the health care needs of our patients first every day. Over the past decade, the state’s hospitals have worked collaboratively to deliver high-value health care that centers around the patient’s needs. South Carolina is a leader in quality and safety of hospital care, providing an example for other states,” Manson said.

Manson said South Carolinians know they can count on their hospitals for quality care and that they wanted them to know they could also count on them when they needed information to make better informed health care decisions. Manson chaired the special SCHA Task Force whose research and discussions led to a recommendation that SC PricePoint be created.

But what hospitals charge and what most patients and insurers pay are two different things.

Hospitals are required to post charges for all services and supplies. These charges are just like the “suggested retail price” of an item or the sticker price of a new car. What consumers and insurers pay is usually a very different rate.

“SC PricePoint data is based on these ‘suggested retail prices. It’s impossible for hospitals to post all of the prices individuals will pay because there are hundreds of insurer contracts and thousands of different insurance and payment plans. What a patient actually pays is largely determined by that patient’s coverage,” Kirby said.

Although the charge data almost always overstates the cost to patients for care, Kirby said hospitals are sharing the information that is available to help move the state toward greater health care price transparency.

All hospitals have financial assistance programs and payment plans for self-pay patients. Therefore, patients without insurance are encouraged to contact the hospital in advance of their care to ensure they understand the true cost and payment options.

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