Total knee and hip replacements cost more in Charleston than just about anywhere else in the country, a new national report shows.
Not only do these procedures cost more money in the Lowcountry, the price variation among facilities that perform the procedures is very wide.
The minimum amount in this area for a total knee replacement is about $27,000 while the highest cost is more than $58,000 for the exact same surgery.
The average cost is about $40,000, the sixth highest average cost among 64 markets included in the January Blue Cross Blue Shield Health of America Report.
Patients, of course, only pay a fraction of these amounts because they’re covered by private insurance, or by Medicare or Medicaid — and depending on their particular insurance policies, they will generally pay the same price for the procedure, no matter which hospital or doctor they choose.
Still, health care price transparency is becoming increasingly important as patients make more deliberate health care decisions.
“I think that we’re probably getting close to a national tipping point,” said Patti Embry-Tautenhan, a spokeswoman for BlueCross BlueShield of South Carolina.
As more health insurance shoppers migrate to plans with high deductibles, they’re becoming more conscious about their anticipated out-of-pocket costs. No longer are they simply paying attention to the amount they spend on their monthly premiums and office co-payments.
“People are seeing cost in a way that is more meaningful to them,” she said. “In the past, this information might have been out there, but they weren’t looking for it.”
Blue Cross and Blue Shield of North Carolina recently launched a public website that allows anyone to compare prices for many different procedures.
“Many consumers believe that the highest cost facility is the highest quality facility, but that’s often not the case,” said Dr. Susan Weaver, Blue Cross and Blue Shield of North Carolina’s chief medical officer. “We know that our customers want the highest quality health care, but like any purchase they make, they don’t want to pay more than they have to. Our tool allows them to make informed decisions about health care just as they would any other major purchase.”
BlueCross BlueShield of South Carolina does not make this information public, except to its members. An online tool called a “treatment cost estimator” allows beneficiaries to estimate how much a procedure, for example, an ultrasound, will cost at many different doctors’ offices, based on their insurance plan. Web traffic for the treatment cost estimator increased 26 percent between 2014 and 2013, Embry-Tautenhan said.
Customers might be surprised by what they find. According to the Blue Cross Blue Shield Health of America report, “Some hospitals across the U.S. charge tens of thousands of dollars more than others for the same medical procedures, even within the same metropolitan market.”
The South Carolina Medicaid agency launched a transparency website one year ago. The department planned to update the site last year so that the public could compare costs for many common procedures, but that information hasn’t been made available yet.
Reach Lauren Sausser at 937-5598.