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In Southwest Georgia, Insurance Costs Run High


Phoebe's dominance has also grown as it has purchased more physician practices. "Doctors you thought would never work for Phoebe are now Phoebe employees," said Sue Luckie, an insurance agent in nearby Leesburg. 

Mullins, the swimming pool contractor, is not surprised. "Some of the surgeons I have built pools for have moved from Jacksonville," across the state border in Florida, he said. "I have said, 'What would you possess you to move here, this isn't a resort area?' They said, 'We get paid twice as much as in Jacksonville.' "

Fair Health, a New York group that assesses customary charges around the country, examined five common outpatient procedures and exams in Albany, Georgia—the largest city in the nation’s  second most expensive marketplace. For Kaiser Health News, Fair Health compared the Albany physician charges to the South Carolina counties that had similar health demographics. All were about the same except for chemotherapy, where Albany doctors charged around $500 for the first hour and South Carolina doctors charged between $200 and $300 less. Real price information about Phoebe Putney Health Systems, the dominant hospital group, are not available.

'They Deliver The Care'

It’s challenging to assess hospitals' prices here because, like most places, contracts between insurers and hospitals are kept private. Morgan Kendrick, president of Blue Cross and Blue Shield of Georgia, the only insurer in the marketplace, said Phoebe is "slightly more expensive" than hospitals in other markets, but the insurer has no other options. 

"There are not many choices from the provider perspective," Kendrick said. "They deliver the care in that area, period, stop."

Joel Wernick, president and CEO of the hospital system, said complaints of high prices are unsubstantiated. "We've not really raised prices or altered our prices in some time," he said in an interview.

But insurance brokers and health policy experts said that Phoebe's rates for private insurers are higher than they would otherwise be to make up for the money the system loses when it cares for the large uninsured population. Aside from MillerCoors and Procter & Gamble, there are not a lot of large employers that hospitals and doctors usually rely on for rich payments. "At the end of the day, if you're an institution this size and you've got a small commercial population, you've got to get that money from somewhere,” said John Crew, a Savannah consultant to hospitals and physicians.

Almost 11 percent of Phoebe's bills were not collected because the services were provided to patients who either couldn’t or did not pay, according to the hospital’s most recent audit. Erik Johnson, an expert on hospital finances at Avalere, a consulting firm in Washington, said the amount of uncompensated care is "very high."

Fri, Jan 31 2014

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