A break on hospital prices in Central PA
Monday, September 14th, 2009
By: Taunya English
tenglish@whyy.org
The Pinnacle Health System in Central Pennsylvania says it's caring for a growing number of people who can't afford their medical bills. The health system is offering a 15 percent price break to uninsured patients, and people who pay out-of-pocket for care.
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The prices that individuals pay is often higher than the rates negotiated by insurance companies and government programs.
Health policy analyst Alwyn Cassil thinks those list prices are inflated. Cassil says hospitals have weathered criticism for their pricing practices in recent years, and she says that scrutiny is pushing hospitals to lower prices and create charity care programs.
Cassil: Those charity care policies are probably a lot more meaningful to people in need of hospital care who can't afford it than some discount off of some highly inflated list price.
The new price change is separate from the system's charity care program. Executives say under the charity care program, an uninsured family with an income near $55,000 usually qualifies for free care. Uninsured families with higher incomes often qualify for a discount.
But some health policy analysts say the discount isn't much of a bargain. Thomas Getzen is a health economist with Temple University.
Getzen: Hospitals have something that they call charges which are approximately the same as the list price on camcorders and stuff like that, that is to say that nobody in their right mind would ever pay that.
The 15 percent discount won't change the amount Pinnacle collects from insurance companies — or government programs like Medicaid and Medicare. Pinnacle's CEO, Roger Longenderfer, says those payers represent more than 50 percent of the system's reimbursement.
Longenderfer says the number of uninsured people seeking care has increased dramatically in recent months.
Longenderfer: They're the ones that need the help the most, they're the ones that are getting hurt by this economy the most, and it isn't going to make a terrible difference in the overall outcome of our financials, but to the individual patient it certainly is going to make a difference.

