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In Mass., Getting Prices in Advance Not Easy

WebMD News from Kaiser Health News

By Martha Bebinger, WBUR

Fri, Feb 7 2014

Here’s an essential question: Is it possible to actually list prices for childbirth, MRIs, stress tests and other medical procedures? And will patients, armed with health care prices, begin to shop around for where (and when) they “buy” care?

Massachusetts is trying to find out with a new requirement that hospitals and doctors tell patients how much things cost, if they ask. It’s part of the state’s health care cost control law and we set out to run a test.

Our shopper: Caroline Collins, a 32-year-old pregnant real estate agent from Fitchburg who is trying to compare prices for a vaginal delivery. Her first call is to the main number at Health Alliance Hospital in nearby Leominster. From there, she is transferred to the hospital’s obstetrics department. A receptionist there tells Collins to call the billing office at UMass Memorial Medical Center in Worcester, which is part of the same hospital network as Health Alliance.

Collins doesn’t mind this transfer. She had intended to get a second price quote from UMass Memorial anyway.

When the phone is answered, Collins launches right in: “I’m due in June and my husband and I have pretty minimal coverage, just a really high deductible, so I just wanted to check and see what the cost would be.” Collins’ deductible is $3,000 a year, but she expects the delivery to cost more than that. She just wants to know how much more.

Collins is directed to the extension of someone named Cathy, who apparently has the price list for services at UMass member hospitals. She leaves a message. Cathy will be out for two weeks.

Collins tries another number in the billing office at UMass Memorial and leaves another message.

She moves on to Emerson Hospital where she’s transferred from the main switchboard four times before leaving a message for a woman who has not called back after two days. Massachusetts law requires a callback within two days.

The only place where she reaches a person who gives her a price after one call is a natural birth center called the Birth Cottage. Their price: $3,000 - $5,000 for a normal vaginal delivery.

A Big Range

Into her third day shopping by phone, Collins gets a return call from a woman at UMass Memorial.

“She did give me an average price,” Collins says. A vaginal delivery would cost “between $10,000 and $16,000.”

If her delivery turned into an emergency C-section, the cost would be between $20,000 and $30,000 “depending on the operation and how it went,” Collins says. For a more exact price, Collins is told she will need a CPT code — a number assigned to any test or treatment you may need. Collins called her obstetrician, but a woman in the front office said she didn’t have the CPT codes and suggested Collins call the hospital back.

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