New law on pricing transparency: Anesthesia $4900/half hour

[Monty Python]

Effective 1 January 2019, the federal government (specifically CMS) requires hospitals to publish their charges online. I looked at one place where my group has the sole contract.

Anesthesia charge from the hospital is $4900 for the first 30 minutes, followed by $89 per minute beyond 30 minutes. This does not include our professional fee (we don't work for the hospital as employees, and our group bills separately for our professional charges). Nor does it include the anesthesia drug charges, which are billed separately by the hospital pharmacy on the hospital master bill.

So what is represented by an anesthesia hospital charge of $4900 for a 30 minute case, especially when that $4900 does not include pharmacy charge nor anesthesiologist professional fee? Use of an anesthesia machine which probably costs $75,000 and has a life span of five years and thousands of cases? Quite a nice ROI. Some piped-in oxygen? What else? Or does this represent why medical price inflation is never-ending?

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[Mr.S]

They probabably bill this but they never see anything close to that.

 

[NICMAN]

They charge that because occasionally out-of-network payers will pay this price. Most states have closed this loophole,however. Virginia requires that we bill the patient directly and the insurance may or may not cover the expense. Sometimes they will but at Medicaid levels.

 

[anbuitachi]

are they including OR use as anesthesia charge?

 

[Mman]

Effective 1 January 2019, the federal government (specifically CMS) requires hospitals to publish their charges online. I looked at one place where my group has the sole contract.

Anesthesia charge from the hospital is $4900 for the first 30 minutes, followed by $89 per minute beyond 30 minutes. This does not include our professional fee (we don't work for the hospital as employees, and our group bills separately for our professional charges). Nor does it include the anesthesia drug charges, which are billed separately by the hospital pharmacy on the hospital master bill.

So what is represented by an anesthesia hospital charge of $4900 for a 30 minute case, especially when that $4900 does not include pharmacy charge nor anesthesiologist professional fee? Use of an anesthesia machine which probably costs $75,000 and has a life span of five years and thousands of cases? Quite a nice ROI. Some piped-in oxygen? What else? Or does this represent why medical price inflation is never-ending?

seems like it is probably the OR facility fee since that is the neighborhood of what many hospitals charge

 

[deleted480308]

Someone has to buy the 6 gown changes for each surgery over an hour so that all the techs can take their breaks

 

[Monty Python]

OR time is billed separately.

"Level 1" OR time is $10K for first 30 minutes, then billed at $5K for each additional 30 minute increment.

"Level 2" OR time is $22K for first 30 minutes, then billed at $11K for each additional 30 minute increment.

 

[Mr.S]

OR time is billed separately.

"Level 1" OR time is $10K for first 30 minutes, then billed at $5K for each additional 30 minute increment.

"Level 2" OR time is $22K for first 30 minutes, then billed at $11K for each additional 30 minute increment.

thats not a lot at all, i always felt that I was ripping the system off

 

[Mman]

OR time is billed separately.

"Level 1" OR time is $10K for first 30 minutes, then billed at $5K for each additional 30 minute increment.

"Level 2" OR time is $22K for first 30 minutes, then billed at $11K for each additional 30 minute increment.

that doesn't seem right IMHO. So for the simplest hour long case the hospital charge is almost $8K for anesthesia and $15K for OR time? That's $23K and you haven't even gotten to the professional fees for the surgeon or the anesthesiologist and it's over $40K for a "level 2" case for the first hour. While I understand there are probably some places that have that level of charge for a facility fee, seems way on the high side both compared to what I know gets charged around me and compared to relatives that have had surgery and I've seen the bills afterwards.

 

[Monty Python]

Those figures were from a nearby HCA facility.

You can download a detailed excel spreadsheet from an HCA facility of your choosing:
Pricing and Financial Information

 

[nimbus]

These are like the rates on hotel room doors that nobody actually pays.

 

[Mman]

Those figures were from a nearby HCA facility.

You can download a detailed excel spreadsheet from an HCA facility of your choosing:
Pricing and Financial Information

the most useful would be to find an insurance EOB for someone that had surgery and see what the charges (and insured discount) were for the procedure.

 

[GravelRider]

I’ve looked at a few hospital websites and they all have disclaimers about how these prices are not the prices that you will actually see. I’m all for price transparency, but what is the point of all of this? It’s incomplete information of an incredibly complex transaction. Do patients really have the ability to “shop around” with this new information? This all just seems pointless to me.

 

[jwk]

that doesn't seem right IMHO. So for the simplest hour long case the hospital charge is almost $8K for anesthesia and $15K for OR time? That's $23K and you haven't even gotten to the professional fees for the surgeon or the anesthesiologist and it's over $40K for a "level 2" case for the first hour. While I understand there are probably some places that have that level of charge for a facility fee, seems way on the high side both compared to what I know gets charged around me and compared to relatives that have had surgery and I've seen the bills afterwards.

My non-discounted pre-insurance calculated rack rate surgical fee was $20k for a shoulder arthroscopy that took less than 45 minutes.