New Jersey leads the country with the highest charges for health care services. According to the below article, charges by hospitals in New Jersey are four times higher than the actual cost. This a serious matter and New Jersey hospitals are not alone in the practice of pricing procedures based on inflated charges that they assert are a reflection of the market. Read the examples in the article and take warning; if you use a non-participating hospital, or are uninsured or have hospital out-of-pocket expenses – never pay the full charge! Medical Cost Advocate may be able to assist you by negotiating your claim and reducing your bill.
Star-Ledger – Trenton Bureau
The pain in Dan Abrams’ leg throbbed so much he could barely stand.
Still, the 60-year-old Somerville resident, who friends say had just canceled his health insurance because of the tough economy, debated from a hospital emergency room whether he should stay and run up thousands of dollars in debt, or take antibiotics from home and hope they arrested the mysterious infection in his leg.
Fearing he could lose his home and flooring business, Abrams chose to leave Somerset Medical Center after a hospital physician said staying would “run him a lot of money,” said Connie Dodd, a close friend who drove him to the hospital and heard the conversation. “I begged him to stay. But Dan’s a proud man. Talk of all the bills got him scared.”
When Connie and her partner, Cindy Weiss, brought Abrams dinner the next night, July 29, they found his lifeless body in bed. Weiss performed CPR but it was too late. “It was a nightmare,” Dodd said.
For people without health insurance, few things are more intimidating than the arrival of a hospital bill.
Nowhere is the sticker shock worse in the country than in New Jersey, according to health experts and a new report by the New Jersey Health Care Quality Institute, a prominent health care policy group based in Trenton.
New Jersey’s hospital “charges” the price list used to negotiate the cost of a bill for the uninsured and for insured people who use a hospital outside their network are four times higher than the actual cost of treating a patient.
For thousands, the charges mean astronomical bills after a hospital stay. Insurers contend they also force higher premiums for anyone with health insurance.
More than 40,000 uninsured New Jerseyans this year will get a bill based on these inflated prices because they make too much money to qualify for financial aid for their hospital stay, according to an estimate by the New Jersey Hospital Association.
Because the charges are used to negotiate prices of everything from treating pneumonia to removing a gall bladder, they inflate health insurance premiums, according to the largest health insurance company in the state, Horizon Blue Cross Blue Shield. And there is no way to know how many people, like Abrams, decline hospital care when confronted with even the possibility of a big hospital bill, said David Knowlton, the institute’s president and CEO.
“Patients forced to pay the charge rate or anywhere close to it are getting screwed,” he said.
Hospital executives say the vast majority of the 1.3 million uninsured people in New Jersey never pay the full sticker price. Charges are used as a negotiating starting point, said Betsy Ryan, president and CEO for the New Jersey Hospital Association.
Knowlton, who chairs Gov.-elect Chris Christie’s transition team for the Department of Health and Senior Services, said he’ll ask for laws to bring charges closer to real costs.
While hospitals negotiate down from the charge price, the system is needed to help them recoup losses elsewhere, said Sean Hopkins, senior vice president of health economics for the New Jersey Hospital Association.
The report also shows the charges at some hospitals can be dramatically higher than at others for the same procedures.
An uninsured stroke patient could receive a bill no higher than $35,000 from Morristown Memorial Hospital. But it inflates to $44,000 at Overlook Hospital in Summit, $57,000 at St. Barnabas Medical Center in Livingston and $114,417 from the Meadowlands Hospital Medical Center in Secaucus, according to the report.
In the 1980s, New Jersey was one of a few states that regulated hospital charges, said Knowlton, who helped create the rules as deputy health commissioner under Gov. Thomas Kean. Facing pressure from suburban hospitals, the state deregulated the system in 1992-93, he said.
Knowlton said the current health care debate has not tackled the issue of cost in the system and wants state lawmakers to take it on.