New law requires hospitals to clearly list prices in 2019

The price of your next hospital visit is now at your fingertips: a potentially handy shopping tool for patients.

“You have to the ability to stop and say ok, ‘My doctor recommended a hysterectomy or a hip replacement. I want to find out what it’s going to cost me and I’d like to know if the hospital in my community are vastly different,” said Dr. James Gilbert, President of Independent Physician Association.

An MRI of the brain at Community Hospital of the Monterey Peninsula costs $1,313. At Natividad Hospital and Salinas Valley Memorial Hospital, the same procedure costs nearly $5,000 more.

Dr. Gilbert said the prices shown on the hospital websites can be misleading. “If I said to you, ‘You’re going to have a hip replacement.’ You say, ‘I’m gonna look this thing up.’ You’d say, ‘$100,000. Wow. How am I gonna pay for that? I get 20% of that?’ In reality, there are contracted rates that are very different,” said Dr. Gilbert.

Dr. Gilbert said Medicare, Medical, and insurers have their own rates worked out with the hospitals and that it could reduce what you pay out of pocket. It is because of this that every patient may leave with a different bill. That is why experts across the state said the new system won’t give patients the full picture of the cost of their hospital visit.

“What would be even more helpful to consumers is not only seeing the price of the service, but seeing the insurance breakdown of how much it is that they are going to be having to pay,” said
Dr. Wendy Patrick, a business ethics instructor at the San Diego State.

Although posting insurance breakdown isn’t required of the hospitals yet, Dr. Gilbert said it is encouraging healthcare providers to be more transparent. “I think this represents a starting point, but its not something that is going to be wonderfully useful to everybody,” said Dr. Gilbert.