Public trust and image are two of the greatest challenges facing healthcare providers.
The American Hospital Association has spent years exploring how patients perceive the healthcare system. For the most part, the findings have been sobering, even disastrous. Words like "anger," "mistrust" and "greed" are used by too many people when they are asked to describe their opinions of providers. The public is convinced healthcare has become a profit-minded big business that is a nightmare to navigate.
But you don't have to work your way to the bottom line to find out why many patients are miffed and baffled by the system. Sometimes it's a simple thing such as a bill sent to the home of a patient following treatment.
I recently had sinus surgery at a top-notch Chicago-area hospital. The experience was painful and messy, although the care was superb, and I'm well on my way to recovery. I was about ready to mail the patient-satisfaction questionnaire back to the hospital when the bill arrived.
I was surprised that the hospital had charged $7,506, which did not include the surgeon's fee, for the outpatient procedure. No complications occurred during my seven hours in the hospital. (I'm fairly certain my PPO will go to the mat so that the overall payment to the providers will be far less than the sum requested in the original bill. I also fully expect to get caught in the trap of overlapping bills and other confusing, nonsensical aspects of the "patient experience.")
But it wasn't the amount charged by the hospital that was most galling. The shocking part was the four-page breakdown. Items like Silastic sheeting for $166, bottled water for $19, disposable blades for $16, eye pad dressing for $240 and one hour in the recovery room for $452 peppered the pages. Not one word on the bill mentioned the terrific care received from the staff. That, to me, was worth a couple thousand bucks.
Itemized billing is one of healthcare's greatest embarrassments, a relic of the widely condemned and costly fee-for-service payment system. If providers are truly interested in upgrading their images, they must support moves to make itemized billing understandable, not something only an actuary could love. How about bills that break down charges by categories, including one for nursing and other human services?
In fact, hospitals are much better off competing on price and quality for each episode of care or performed procedure. The amount of bottled water the patient consumes is irrelevant.