Northeast Georgia residents who need hip replacement surgery should consider shopping around for the hospital and physician with the best price.
Prices for hip replacement procedures ranged from about $11,000 to more than $125,000 at 120 hospitals across the United States, according to a new study that made national headlines when it was released in early February.
“That’s the equivalent of the same Honda Civic costing different prices at different dealers,” said Dr. Peter Cram, an author of the report published online in Journal of the American Medical Association Internal Medicine. He is a University of Iowa associate professor of internal medicine.
Charges for Hip Replacement Vary Widely
People in Georgia who are considering hip replacement – or other non-emergency surgeries – can do similar research on their own behalf. And they are sure to find that charges are all over the map.
The figures cited in the study represent a “bundled price,” which combines the surgeon’s fee with hospital charges. To obtain the estimates, lead author Jamie Rosenthal posed as the granddaughter of an uninsured 62-year-old woman who planned to pay cash for a hip replacement.
Rosenthal contacted two hospitals from each state and the District of Columbia, as well as U.S. News and World Report’s 20 top-ranked orthopedic hospitals. She was able to obtain answers from about 60 percent of the hospitals she contacted.
The fact that 40 percent of hospitals didn’t provide a price is not surprising because of the variables that make up the fee, according to Dr. Ezekiel Emanuel, chair of the department of medical ethics and health policy at the University of Pennsylvania.
That said, “the range [of prices] being so large I think is a bit unexpected and depressing,” Emanuel said.
Compare Prices in Northeast Georgia
Prices also vary at hospitals in northeast Georgia, although the range is narrower. Athens Regional Medical Center provided an estimate of about $27,000 in hospital charges for an uninsured patient paying out-of-pocket.
A call to Northeast Georgia Medical Center in Gainesville obtained an estimate of $11,000 to $13,000 for an uninsured patient able to pay cash. St. Mary’s Hospital provided a range of $20,000 to $35,000. These figures are for the hospital stay and don’t include what surgeons charge.
Patients in the Athens area will find that physician prices also vary. Estimates for Athens Orthopedic Clinic surgeons, who perform hip replacements at St. Mary’s and Athens Regional, ranged from $7,000 to $12,000 for an uninsured patient paying out-of-pocket. A call to Athens Bone and Joint, whose physicians also work at both Athens hospitals, returned an estimate of around $2,500.
Why do prices vary?
Price differences could result from differences in amenities offered and drugs used, as well as differences in how charges are calculated. Individual patient complications and recovery needs can also affect the price paid. Some hospitals offer discounts for prompt payment of bills.
The ten-fold variability in hip replacement costs that the national study documented could also be due to salaries of the hospital staff and the medical equipment used, according to Jayani Jayawardhana, assistant professor of health policy and management at the University of Georgia.
According to the University of Iowa’s Cram, people with and without insurance need to know what surgical procedures are going to cost.
“Many people have insurance, but they still are on the hook for part of the price of whatever they are getting,” said Cram. Large co-payments for surgical procedures often come as a surprise for people who are used to paying only $20 for an office visit.
Compared with people without health insurance, people with insurance are fairly insulated from charges and are less motivated to shop around, according to Christina Marsh, assistant professor of economics at UGA.
If patients plan to comparison shop, “price data is not valuable separate from quality information,” Emanuel said.
“Make sure your surgeon is good by any means you can,” Emanuel said. “Find out how many [operations] they’ve done, try to get some complication rates.”
Patients can also look at hospital quality using Medicare's HospitalCompare.gov website.