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Penn State Health offers new pricing tool that estimates out-of-pocket medical costs

Written by Min Xian/WPSU | Aug 14, 2019 4:54 PM
Penn State Hershey Medical Center.jpg

The Penn State Hershey Medical Center. (Photo submitted by Penn State Hershey)

Penn State Health is offering a new pricing tool for patients to estimate the cost of common medical procedures, a function that the organization said will improve healthcare cost transparency

The online pricing tool requires patients to enter their personal information and insurance details. Then users can select from a list of dozens of medical procedures like ultrasound or knee replacement and get an out-of-pocket estimate. 

Dan Angel, vice president of revenue cycle at Penn State Health, said the online tool is available to anyone considering care at a Penn State Health facility, including the Hershey Medical Center and the Children's Hospital. 

Instead of a broad database, he said the tool is customized. 

"You are getting an estimate of the cost of your care based on your specific insurance benefit," he said. "No one patient is the same. So, it is definitely a personalized tool for the consumer."

Angel said patients can benefit from this information when making healthcare decisions, but cautioned that it's only an estimate.

"This is not a perfect science in the industry, and things can change," Angel said. "You may go in for a specific procedure. And based on the clinical conditions of that time, things may change and additional services or procedures may occur."

The Centers for Medicare & Medicaid Services, or CMS, currently maintains a database of standard charges for medical procedures, but Angel said Penn State Health's tool is different, because that database doesn't take into account patients' insurance policies. 

"There are obviously a lot of variables that go into the price that the patient is incurring," Angel said. "So that CMS regulation, although a step toward transparency, can be a bit deceiving, because the charge that the consumer sees is not what the consumer is going to pay."

Last month, the Trump administration proposed a rule that would require hospitals to publish the prices they negotiate with every insurer on drugs, supplies and other services. The administration says the rule would increase transparency and lower healthcare costs. 

Angel said, since the pricing tool was released in July, Penn State Health has seen more traffic on its website.

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