Buried in the back of the report is a list of what Montana's 11 largest hospitals charge for a dozen common procedures, from baby deliveries to treatment for “chest pain.”
As you might guess, it isn't cheap to get sick and visit the hospital.
Having a baby isn't quite as pricey at $5,300, but if you undergo a Caesarean section birth, add another $4,000 to that average price.
And these costs don't include the charges of physicians, radiologists, anesthesiologists or other health professionals who provide their services at the hospital.
So what's a consumer to do when confronted with these sometimes shockingly high prices for medical care? One answer that's being peddled now is “comparison shopping,” based on the notion you can compare prices at different hospitals, and get the best deal.
Whether this makes much difference (or whether you can legitimately make a choice when you're in a health emergency and on your way to the nearest hospital) is questionable.
But there are sources to help you, the consumer, compare prices.
At the Montana Hospital Association's Web site, www.mtha.org, you can click on a tab titled “Information Service for the Public” and then go to another one, “Comparing Charges at Montana Hospitals.”
What you get is not a true comparison. The MHA has listed 19 common procedures, a range of prices at all Montana hospitals and the average charge, based on prices from July 2006 to June 2007.
If you want to find out the price at a specific hospital, you have to call. The Web site has a link on the same page that gives you the name and telephone number of the person you should call at nearly 40 hospitals, including the state's 11 largest. The list is updated every six months, and the next scheduled change is this spring.
Other states have set up more extensive price-comparison Web sites that list specific hospitals and their prices.
Bob Olsen, a vice president at MHA, says Montana hospitals decided more than a year ago against providing that level of detail.
He says even with the more extensive lists in other states, consumers still had to call the hospital and check the current price, and that most of those lists had only “in-patient” care, which are procedures where the patient stays at the hospital at least one night.
The Montana list has several out-patient procedures, such as shoulder rotator-cuff surgery, cataract surgery and colonoscopies.
“I think there is a presumption that this is being done everywhere else and that it's a grand success, and that's just not the case,” Olsen says. “It's definitely a work in progress.”
Olsen says Montana's hospitals may revisit the issue and decide whether to provide more hospital-specific information.
As for medical-related bankruptcies in Montana, McGrath's report provides some startling statistics - but it's not clear what the stats mean.
The Jan. 16 report said that from 2004-2006, there were 17,700 “cases” of hospital bills involved in bankruptcies in Montana, totaling $19 million in unpaid bills. That sounds like an awful lot of bankruptcies tied to hospital bills.
But the person who compiled the statistics could not be reached late last week, and no one else in McGrath's office could say what constitutes a “case.”
One thing it doesn't mean is an individual bankruptcy filing, because from 2004-2006, personal bankruptcy filings in Montana totaled about 10,300.
A “case” may be an individual hospital or medical bill in a bankruptcy filing, among scores of unpaid bills faced by the person filing for bankruptcy. One person's bankruptcy filing could have multiple health-care bills.
Whatever it means, it seems pretty clear that medical bills play a prominent role in personal bankruptcy filings in Montana.
The report also noted that hospitals get only about 1 percent of their bill when a case goes into bankruptcy. But to say hospitals “pursue” people into bankruptcy would be incorrect, Olsen says.
Olsen says neither hospitals nor their bill collectors know if someone is going to file for bankruptcy. If someone is having trouble paying a hospital bill, the hospitals encourage them to talk to the hospital and work out some sort of payment plan, he says.
Only when a patient ignores a bill and does not contact the hospital does the bill end up going to a collection agent, usually three to six months after the service, he says. And having a person file for bankruptcy is the last thing that a hospital or a collector wants to see,
Olsen says.
When someone files for bankruptcy, the hospital is an “unsecured creditor,” meaning it goes to the rear of the line of people trying to collect a portion of unpaid bills by the person who filed.
What role the hospital bills played in the bankruptcy decision is not known, Olsen says.
“They're usually in financial difficulty across a lot of pieces of their life,” he says. “They may have medical bills, they may have credit-card debt. People don't typically just have a hospital bill and need to go bankrupt to avoid a hospital bill.”
Mike Dennison is a reporter at the Missoulian's State Bureau in Helena. He can be reached at 1-800-525-4920 or at mike.dennison@lee.net.
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