Patients need, and will soon have, a better way to compare health costs

Editorial by Wilmington Star-News, September 5, 2013.

Susie Yeuell was twice bitten – first by a feral kitten and then by the billing department of New Hanover Regional Medical Center, where she had a series of preventive rabies vaccines as a result of the cat bite. Her bill came to nearly $17,000 – about $13,000 more than should have been charged.

That second bite probably hurt worse than the first.

Yeuell's was not an isolated incident. The hospital overbilled people who have been unlucky enough to need a rabies vaccine by a total of $200,000. They or their insurers will be reimbursed, thanks to Yeuell's persistence and repeated inquiries from a pesky StarNews reporter. That glitch, attributed to a billing code error, is fixed, says a hospital spokeswoman, but let this be a lesson:

Check your bill, ask for an itemization – and don't be afraid to challenge charges you believe are unfair or that are inflated.

The series of vaccines is one of thousands of items billed by hospitals. Computers do the heavy lifting, but someone has to code the information into the system. The wrong code can lead to delays in payment as well as overcharges for the patient. In Yeuell's case, her insurer billed her $2,426 – her share of the $16,943 bill.

The same procedure was quoted at $3,000 at Novant Health's Brunswick Medical Center, and $8,000 at the Vidant hospital in Greenville.

Which illustrates another point.

We have a health care pricing system that makes no sense. The cost of the same procedure can vary greatly based on whether you are insured and which insurance you have, as well as the individual provider.

Insurers negotiate discounts, but uninsured patients are billed for the whole amount.

Complex billing codes and medical jargon make it difficult to decipher bills, even when it is itemized.

Thankfully, the Honorables took a break from passing divisive legislation to come together on a provision that offers help for the weary health care system navigator.

By next June, hospitals and other medical providers will have to post prices for their most common procedures. And bills should become more organized and easier to read. Although health care isn't quite like shopping for the best deal on a TV, the ability to compare prices may lead more patients to question why there is such a disparity in pricing.

While costs will vary some and no two cases are identical, wide ranges in the cost of the same procedure in the same region should raise eyebrows. The United States spends more on health care per patient than any industrialized country. There are many reasons for this – the convoluted pricing system and a system in which seemingly no two patients pay the same price for the same care are only part of the complex equation.

However, the quest to fix the many flaws in our system will be greatly enhanced if the patients are empowered with information they didn't have before, such as what you'll pay for a common procedure at one hospital versus what the medical center in the next county charges. Some pricing information already is available through cms.gov, the website of the Centers for Medicare and Medicaid.

North Carolina residents will soon be able to get that and other information as part of a bipartisan bill aimed at injecting a little bit of order into an otherwise confusing system of health care pricing and delivery.