Price transparency: Sikeston hospital now details cost of surgery to patient

SIKESTON, Mo. — Six months of work, testing and trials culminated Monday with a simple phone call from Missouri Delta Medical Center to a patient.

The hospital employee was reminding the patient about an upcoming scheduled service, and together, they completed the registration process. Now, on the day of the surgery, the patient could skip the front admissions office and go directly to the department where the surgery was to be performed.

But the call included more than just an opportunity to check in.

MDMC, in partnership with the Orlando, Florida-based company PatientMatters, also was able to detail the costs of the upcoming surgery and the patient’s financial responsibilities.

Sharon Urhahn, MDMC director of marketing, called it price transparency.

“Most things, you know what you are paying for when you buy them — whether it is a car or furniture or whatever. With health care, you just would go do it and never know what you were going to owe,” Urhahn said.

Through PatientMatters, she said, the hospital has the technology to provide the cost information up front.

Mark Mancuso, site director for PatientMatters, said patients will receive a price estimate based on the deductible they may have incurred so far and the contracted amount approved by the insurer for the procedure. MDMC can determine how much the patient’s co-insurance will pay, as well as other factors.

“This way, we can inform the patient ahead of time of what their financial responsibility is, and they can be prepared ahead of time,” he said.

Through PatientMatters, hospital staff will offer patients a variety of payment choices.

If the entire cost of the procedure is not covered by insurance, the patient will have the option of setting up a repayment plan or using a zero-interest loan program with repayments scheduled over two- or four-year periods.

Implemented last fall, the repayment plans have proven popular and feasible for patients, Mancuso said, noting the average payment is $58 per month, typically over a 24-month period.

Several of those taking out a 0 percent loan have paid off their balances early, he added.

Mancuso said he likes the level of advocacy the hospital can offer patients — particularly those with Medicare and no secondary coverage or those needing assistance obtaining Medicaid or other similar programs.

PatientMatters at MDMC has hired April Lambert to work with patients to determine what other resources are available for them to assist with their medical costs.

Greg Carda, MDMC’s vice president of finance, said he considers the advocacy one of the best aspects of the hospital’s new program.

“We have dramatically increased the number of patients made eligible for assistance either through Medicaid or other programs, and this all comes with no additional cost to the patient,” Carda said. “It is a benefit they were eligible for but just weren’t aware of or hadn’t been able to take the time to apply for. With PatientMatters, we do this for the patient.”

While acknowledging some patients would rather not have a conversation about the cost of medical procedures, Carda said statistics show satisfaction is higher for patients who are able to plan for their financial obligations ahead of time.

“A person is naturally apprehensive when you quote a big number to them, especially at the beginning of the year; however, once you apply the insurance company’s discount and take it down to what their amount is, then when they hear that dollar amount, if they say, ‘Well, I can’t afford that,’ that is OK. Now we can say, ‘The hospital has different options available for you.’ We are trying to work with the patient,” Carda said.

Armed with more knowledge about their health-care costs, Mancuso said patients are less likely to cancel procedures and more likely to review their hospital statements.

Pertinent address:

1008 N. Main St., Sikeston, Mo.