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Published June 08, 2013, 11:51 PM

Comparison shopping for health care no easy feat

Complex variables make accurate price menu difficult
FARGO – It took Nicole Haaland three weeks to figure out she couldn’t afford the treatment doctors recommended for her back pain.

By: Kyle Potter, INFORUM

FARGO – It took Nicole Haaland three weeks to figure out she couldn’t afford the treatment doctors recommended for her back pain.

She got “the runaround” before discovering the nerve-dulling injections at the Sanford Brain and Spine Center would cost $5,500 a year – too much, she said. By then, she had already shelled out $1,500 for tests to see if that treatment would work.

Officials from the two local health systems say they do their best to help patients understand the possible cost of a procedure, but it’s hard to make “price-shopping” a reality.

Between deductibles on different insurance policies, the various government programs that help cover costs and the often unpredictable nature of medicine, it takes work to come up with even a ballpark estimate of a patient’s out-of-pocket costs.

The Center for Medicare Service’s data on hospitals’ average costs for some of the most common treatments gives a glimpse at how prices may differ between Sanford Medical Center and Essentia Health. Those differences are generally minimal.

But as throughout the rest of the country, there are some wild swings in prices for the same procedure at two hospitals in the same area.

In 2011, the newest data available, Sanford averaged $1,200 for an echocardiogram, a common procedure used to detect heart disease or other heart defects. It was nearly half that at Essentia, at $603.

At Essentia, a pacemaker implant cost an average of $33,515 in 2011, nearly 30 percent more than at Sanford.

Dr. Gregory Glasner, president and chief medical officer of Essentia’s west region, cautioned that those prices aren’t what an everyday patient receiving that treatment would actually pay. Glasner said he sympathizes with Haaland’s frustrations, but there’s no way to build an accurate price menu that patients can look at before going under the knife.

“I wish it was that realistic,” Glasner said. “It is so complex. I don’t think it’s possible to do that in the way that health care financing has evolved.”

That’s why Essentia sends anyone who asks about cost to an on-staff financial counselor to determine an out-of-pocket cost estimate, Glasner said.

Sanford staff will put together a price assessment by factoring in previous charges for the same procedure, said Doug Okland, Sanford Clinic Fargo region’s chief financial officer. But while an estimate for an MRI, X-ray or lab test may be cut-and-dried, the costs of other treatments are too variable, he said.

“You don’t know exactly what they’re going to get until they come in. It really depends on what occurs during that procedure,” he said.

Or, as the North Dakota Hospital Association’s Jerry Jurena put it: “The body is just as complicated as our system is for charging.”

It’s been three years since Haaland was considering getting the treatment called a medial branch block for her back. Since then, she’s turned to physical therapy to help ease the pain, a product of a nasty car wreck in 2007.

But she still remembers none of her doctors seemed to have any sense how much the medial branch block would cost her.

“They’re not paid to worry about insurance,” she said.

That’s just the way Glasner prefers it.

“I don’t want (doctors) to know. I don’t care if they know,” he said. “I want them to take care of the patient.”

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Readers can reach Forum reporter Kyle Potter at (701) 241-5502