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The Healthcare Transparency and Medical Tourism Rise
Why is My Bill Larger than Yours if we had the Same Procedure?
The same medical procedure can vary in costs throughout the U.S. states or cities. Transparency of the healthcare providers is still a major issue that is on the government agenda, yet, we still have a long way to go. Until then, people are going for medical tourism opportunities to get the best treatments at a lower price.
6/25/2013, Denver, CO: Medical providers have long known that geography plays an important role in the cost of medical procedures, surgeries, and facility costs. For example, someone who has a heart attack with major complications who also needs four stents might be billed approximately $166,000 in one hospital, but only $90,000 in another. In fact, a recent article in the Washington Post showed that hospital costs and bills can vary by up to 300% for the exact same service, and it isn't just a matter of geographical location.
Because of such pricing disparities, more consumers are considering, and taking advantage of medical tourism abroad. The bottom line is that, in the U.S., billing costs and reimbursement capabilities are determined by hospital ownership (such as the difference between a non-profit hospital and a profit hospital) that has nothing to do with the surgery itself.
Check out the costs in Florida for cellulitis treatments. The national average is approximately $10,000, but some states offer the surgery for $8,000, while the highest state averages reach upward of $40,000. Side-by-side comparisons between Colorado and California show a wide disparity of cellulite treatment costs. In California, the cost is of approximately $38,000, while in Colorado, you'll pay closer to the national average of about $14,000. In Iowa, you'll pay about $9,000.
Are you in the wrong state to get a fair price?
No wonder people are looking for other options, such as health tourism, where less variability and more transparency is the norm. It makes sense – on the wallet and in excellence of care.
“The combination of price disparities and lack of transparency have compelled growing numbers of patients to seek global solutions when it comes to their medical care,” states Pramod Goel, CEO and founder of PlacidWay, a leading medical tourism resource and provider based in Denver, Colorado.
“People want to see and explore their options when it comes to choices, prices and accessibility when it comes to treatments, procedures and surgeries.”
Why the Disparity in Healthcare Costs?
National health providers determine average costs of some of the most common inpatient procedures. Until very recently, the standards and guidelines for setting average prices has been secretive. New legislation regarding transparency in healthcare, as well as how healthcare costs are determined, have proved quite a shocker to consumers.
Consumers demand greater transparency in the healthcare realm, as how it should be. Why should one insurance company charge one amount, while another charges something different? In some instances, Medicare and some private insurance companies such as United Healthcare, Anthem Blue Cross/Blue Shield, and Aetna are able to negotiate lower charges with hospitals throughout the country. Again, a viable reason for why many consumers are opting for foreign medical care and excellent JCI-accredited hospitals, which are not afraid of transparency.
While some pricing transparency among hospital facilities has increased (previously, hospitals were not allowed to do so), comparison-shopping between hospitals is no easy task. Itemized billing descriptions in the hospital’s charge master have always been developed to meet the parameters set by health plans and government oversight.
Costs in the charge master are determined by a mixture of costs and services, including facility, facility improvement costs, labor costs, technology (current and projected), as well as competitive marketplace and the number of uninsured patients treated by a specific hospital.
The cost of a nose job in Malibu, California will be different from the cost provided in Fargo, North Dakota, due to the type of facility, demand, population, and so forth. Supply and demand also determine a wide variety and disparity between the pricing of similar procedures, as does the expertise, technology, and approach to surgeries. This is why people choose health tourism.
State healthcare providers have long shown variation among common procedures including joint replacements, cardiac care, and lung treatments. Often, pricing is determined by demand and demographics, as well as geography.
For example, some of the most populated states in the United States, including California, Texas, Pennsylvania, Florida, New Jersey and Nevada, have higher prices, while Northern states such as North Dakota, Idaho and Montana offer lower prices. Los Angeles, California has some of the highest variations in costs, compared to facilities within the same state, charging between $78,000 and $273,000 for the treatment of similar patients requiring a ventilator.
Traveling to other countries might mean getting a lower cost treatment and a health vacation, or at least enjoying the beauty of the breath-taking scenery. Places like Costa Rica, Turkey, India, South Korea, are known to be ideal for recharging your batteries. However, final costs are very important.
“It’s no wonder consumers are fed up with rising medical care costs,” concludes Goel. “Traveling domestically or abroad makes sense in order to get the best deal.” However, one important thing to remember, even with the disparity of prices, is that the most expensive is not necessarily the best. The pricing of procedures, surgeries and treatments is tied more to a country's health care delivery system, and not the quality services (or lack thereof) offered by a solitary healthcare provider.
About PlacidWay the medical tourism company:
For more information about medical tourism, email [email protected] or call us at +1.303.317.3607.
Learn more about Medical Tourism:
2013-06-25 / Updated on: 2021-01-08