GUIDE OFFERS WAY FOR HEALTH CARE BUYERS TO SHOP

A state publication lets consumers of medical services shop for the lowest prices on a number of services at area hospitals and surgical centers.

The Missouri Department of Health has released its fourth "Buyer's Guide" for outpatient procedures ranging from cataract removal to treadmill stress tests.

The guide compares costs at several hospitals and surgical centers from Farmington to the Bootheel, including Southeast Missouri Hospital, St. Francis Medical Center, Doctors' Park Surgery, Missouri Surgery Center and Cape Girardeau Outpatient Surgery Center, all in Cape Girardeau.

In addition to listing costs for several specific procedures, such as tonsillectomies, the guide also cites facilities with consistently high or low charges for different procedure groups, such as eye operations or ear, nose and throat procedures.

Doctors' Park Surgery Center is cited as having consistently low charges in six of 12 procedure groups. Southeast Missouri Hospital shows consistently low charges in four procedure groups, and consistently high charges in three.

St. Francis is listed as having consistently low charges in four procedure groups, and consistently high charges in one.

Also cited in the guide are Lucy Lee Hospital of Poplar Bluff, Doctors Regional Medical Center of Poplar Bluff, Twin Rivers Regional Medical Center of Poplar Bluff, St. Genevieve County Memorial Hospital of St. Genevieve, Pemiscot Memorial Health Systems of Caruthersville, Madison Memorial Hospital of Fredericktown, Arcadia Valley Hospital of Ironton, Dexter Memorial Hospital of Dexter, Missouri Delta Medical Center of Sikeston, Mineral Area Regional Medical Center of Farmington, Parkland Health Center of Farmington, Ripley County Memorial Hospital of Doniphan, Perry County Memorial Hospital of Perryville and Reynolds County General Memorial Hospital of Ellington.

Garland Land, the health department's resources director, said the guide is intended to help consumers make more informed choices about health care.

"In the past, the health care system has basically not provided opportunities for the consumer to be involved in decision-making," Land said. The guide lets them "make comparisons like they do in making any other purchase."

Price information is important, Land said, but it shouldn't be the only factor consumers consider when choosing a hospital or surgery center.

"In general, we think a person should look at price," he said, adding that other factors in the consumer's choices are the number of procedures done, the different qualities of the institutions and doctors.

But Michael Jones, executive director of Missouri Surgery Center, says insurers and consumers have to factor price into their medical decisions.

"In today's insurance arena, where almost everyone has co-payments and deductibles, people are out shopping for quality and price," Jones said. "Quality is very hard to measure. Price is not."

Ambulatory surgical centers like the one Jones runs are becoming more and more popular as industry and consumers look for "lower-cost alternatives," he said.

John Fidler, president and chief officer of St. Francis, said consumers need to make sure they're not comparing apples to oranges while they're shopping surgical centers and hospitals.

"One's open 8 to 5 by appointment only, has minimal services," he said. "The other is open 24 hours and is equipped to handle life or death emergencies. There's a big difference. It's not apples and apples."

He said consumers need as much information as possible, but added, "I think the first thing I would shop for is the best surgeon."

Fidler also pointed out that hospitals tend to get patients who are older and at a higher risk for complications from treatment, thus pushing costs up.

In Cape Girardeau, the cost for hernia repair surgery ranges from $1,365 -- the lowest charge in the region -- to $3,763, according to the guide. The regional median charge for the surgery is $2,220, while the state median charge is $2,437.

The charges for carpal tunnel release procedures range from $973 to $1,435 in Cape Girardeau. The regional median charge is $1,501, while the state median charge is $1,699.

BUYER'S GUIDE FINDINGS

The guide also made several findings about costs for health care in the region in general.

Overall, facilities in the region were most likely to lower their charges by 5 percent or more.

More than $1,000 separates the highest and lowest facility charge for most procedures.

The highest facility charges for a particular procedure are usually two to three times more than the lowest procedures.

Facilities that had consistently low charges in 1994 were likely to have consistently low charges in 1995. And facilities in Southeast Missouri were the least likely in the state to show up again in the consistently high charge category.

Ambulatory surgical centers generally have lower charges than hospitals.

The range of charges for procedures was narrower this year than in 1994 for more than three-fourths the 50 procedures studied.

Charges are most uniform among facilities for diagnostic procedures such as CAT scans and MRI scans.

The guide is available from the Missouri Department of Health, P.O. Box 570, Jefferson City, Mo. 65102. Cost is $3 per copy.