What will a hospital visit cost you?

Feb 13, 2014 by AFP


12 Feb 2014

Dear Arizona Health Care Consumer,

Two weeks ago, I asked you to contact your three closest hospitals to get their Direct Pay Prices. I never ask activists to do something I wouldn’t, so I contacted my three closest hospitals. Further below, I’ll tell you what I found…

Thanks to the Direct Pay Price health care transparency reform bill that AFP-Arizona activists helped pass last year in the Arizona Legislature, you can now help yourself — and your friends, family members and neighbors — at the very same time!

Ever left a hospital, and found yourself stuck with an outrageously expensive bill? Now, with the Direct Pay Price law in effect, you can prepare yourself in advance, and keep yourself from getting gouged by hidden prices. This will be especially important now, as ObamaCare goes into effect and raises health plan deductibles and increases out-of-pocket costs for Arizona families. With that increased exposure, you may find yourself having to pay cash directly for hospital services — so you need to start shopping now.

Thanks to the Direct Pay Price reform, large medical facilities (over 50 beds) must provide cash prices for the 50 most common medical procedures. Facilities with fewer than 50 beds must provide cash prices for the 35 most common medical procedures.

Further below, I’ll tell you how to TAKE ACTION. But first, here’s what I found when I shopped around…

My kids and I have had terrible coughs this week, so I checked on the prices for pneumonia treatment at the four hospitals nearest me.

Banner Good Samaritan: For simple pneumonia with complicating conditions, BSG listed a direct pay price of $61,734. But the discounted self-pay range for qualifying uninsured patients was from $3,806 to $10,220. According to the fine print, “Prices are subject to change without notice.”

Scottsdale Health Care: At SHC, simple pneumonia with complicating conditions had a direct pay price of $29,798, but that did not include physician fees. The “average direct pay price” was $19,368, and “average prompt pay price” (payment within 14 days of dismissal) was $8,976 — again, not including physician fees.

Phoenix Children’s Hospital: The average direct pay price for RSV pneumonia and bronchiolitis ranged from $12,235 (“minor severity”) to $67,355 (“extreme severity”).

Maricopa County Hospital (MIHS): The direct pay price for simple pneumonia with complicating conditions was $8,357.75 (thanks to Lyle Tuttle for sending me the link).

What would I do, if I faced a $12,000 out-of-pocket family deductible under ObamaCare? First, I would do my best to go to my nearest urgent care, Doctors Express, where I could buy every single item on the self-pay price list for less than the lowest quoted price at theĀ four hospitals. (The nearest NextCare facility is not yet compliant with the law…) Next, I would find out what it takes to qualify as an “uninsured patient” at Good Sam… Finally, I would (and I will) keep shopping around at other Valley hospitals to see if I can find something more reasonable. YOU can help, too…


Please call, email or write the three hospitals (or urgent care centers, or imaging centers) closest to you and ask that they send you their DIRECT PAY PRICES today — as REQUIRED BY LAW under Arizona Revised Statutes 36-437.

Here is a sample phone or email script:

“Pursuant to Arizona Revised Statutes 36-437, I am requesting that you send me all of the direct pay price information that is required under the statute. There is no EMTALA (pronounced “Em – tall – uh”) issue at the time this request is being made. Please send the requested information in full to the following address [fill in your address]/to my email. Thank you for your prompt compliance. Sincerely, [your name]”

Of course, price is never the only factor when it comes to making health care decisions. But if your doctor tells you that the three hospitals nearest you are equal in quality, why not go to the most cost-effective one?

And please help your neighbors, too! When you get price lists from local hospitals, please send us those lists — PDF format is the best for us — or the links to the hospital web pages showing the direct pay prices. We will soon put those prices on a user-friendly website and thus do our part to generate competition that will drive those prices down even further. And if a hospital refuses to send you a list of prices, please tell us that: we will do our best to publicize that fact and try to shame them into complying with the law.

Our ground address is: Americans for Prosperity, One East Camelback Road, Suite 550, Phoenix, AZ 85012. Our email address is: infoAZ@afphq.org

For Liberty, Tom

Tom Jenney
Arizona Director
Americans for Prosperity
(602) 478-0146