On Hospital Price Transparency and Estimating Out-of-Pocket Expenses

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When it comes to health care, determining medical costs can be complicated

[By Dr. David Edward Marcinko MBA CMP™]

Dr David E Marcinko MBAAt Baptist Memorial Health Care, they’re trying to make things a little easier to understand. That’s why they built Expense Navigator, an out-of-pocket medical cost estimator tool. As a doctor, patient and financial advisor, this is vital information.

Expense Navigator is a key step in Baptist’s effort to become a leader in price transparency in U.S. health care. Patients can use the medical cost estimator tool to estimate out-of-pocket costs for hundreds of hospital inpatient or outpatient procedures.

They can also get a customized estimate for care at Baptist Memorial Hospital-Memphis or 13 other affiliated hospitals in West Tennessee, North Mississippi and East Arkansas.

So, whether you have Medicare, other insurance or are uninsured, the Expense Navigator may help you better plan for Baptist medical expenses.

Some of the Procedures Listed

  • MRI
  • CAT Scan (CT)
  • Emergency Visits (ER)
  • Mammogram
  • Orthopedic Procedures
  • X-Ray
  • Ultrasound
  • Childbirth
  • Bone Imaging
  • Cardiac Procedures
  • Appendectomy
  • Chemotherapy
  • Laparoscopy (Scope)
  • Pulmonary Procedures
  • Upper GI
  • Lower GI
  • Spinal Tap
  • Lab Tests
  • Diabetes Treatment

Free, out-of-pocket medical cost estimates are available for the following hospitals in Tennessee, Mississippi and Arkansas






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Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com


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6 Responses

  1. Medicare to pay for SEX … changes?
    Medicare coverage ban on sex-change surgery lifted.


    Ann Miller RN MHA


  2. Hospital Outpatient Prices vs. Physician’s Office or Other Community-Based Setting Prices

    According to a study from the National Institute for Health Care Reform (NIHCR), average hospital outpatient department prices for common imaging, colonoscopy and laboratory services can be double the price or more for identical services provided in a physician’s office or other community-based setting.

    The average hospital outpatient department price for a basic colonoscopy, for example, was $1,383 compared to $625 in community settings. For a routine blood test-a comprehensive metabolic panel-the average price in hospital outpatient departments was triple the price-about $37 compared to $13 in community settings.

    The average price for magnetic resonance imaging (MRI) of a knee was about $900 in hospital outpatient departments (HOPDs) compared to about $600 in physician offices or freestanding imaging centers. Likewise, HOPD average prices for physical therapy were much higher than community settings. For example, a 15-minute unit of manual therapy was $58 on average in HOPDs compared to $35 in community settings.

    Source: National Institute for Health Care Reform


  3. Health costs, journalism and transparency


    This new site is opening the door to price data.

    Dr. Burke


  4. Price Transparency
    [Revealing MRI Prices Triggered Competition]

    According to a study by WellPoint subsidiaries (AIM Specialty Health and HealthCore), consumers that chose cheaper MRIs after obtaining price information saved $220.00 for each exam in health system costs. Competition grew between hospitals due to a shift in consumer behavior.

    The data is as follows:

    • >30 hospitals lowered MRI pricing to stay competitive in marketplace.
    • MRI price increased $125 without education program.
    • MRI price decreased $95 with education and price transparency.
    • MRI price decreased $175 after program was implemented.
    • MRI price range from $300-$3,000.
    • 30% in program group had no cost sharing.
    • 15% who were part of AIM outreach went with a different provider.

    Note: Data from 100,000 members (WellPoint) from 2010-2012. 61,000 members were part of an education program (AIM). Participants were compared to 44,000 members who did not have an education program.

    Source: WellPoint, Inc.


  5. Transparency Takes Off

    Hospitals are using a variety of strategies to answer patient, payer and employer calls for price and quality data.




  6. Out of Pocket Costs



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