Bill would give patients advance notice of costs

Kirsten Searer

Tuesday, April 12, 2005 | 11:06 a.m.

CARSON CITY -- Hospital patients would get advance estimates about the costs of their planned care if Assembly Bill 545 clears the Legislature.

Proponents argued that patients often have no idea how much their procedures will cost until they get a final bill.

Their health care provider might charge significantly more than other providers, or the costs might be so high that an insurance company won't cover them, said Scott McKenzie, executive director of the State of Nevada Employees Association.

The bill includes provisions that doctors do not have to quote charges when an unexpected complication arises, though those charges would be detailed separately.

McKenzie compared the idea to quotes that people get from auto mechanics before they take their car in for repairs.

Fifteen state legislatures have passed measures requiring hospitals to disclose prices, said Sally Taylor, who spoke on behalf of the American Federation of State, County and Municipal Employees.

Some states require that full pricing lists be printed out, while others simply require estimates for the top 25 most common procedures, she said. But some bills can be very confusing, using codes or detailing pages of procedures, she said.

"Health care consumers do have to be pretty savvy these days, as I think we all can agree," Taylor said. "But they shouldn't have to have a degree in hospital administration."

The prices will help hold health care providers accountable, she said. She did warn that organizations also need to keep an eye on quality of care as well as cost.

Bill Welch, president and chief executive of the Nevada Hospital Association, said the measure would end up raising prices as hospitals struggled to deal with the paperwork.

"This is going to be a cost that's going to be passed on," he said. "It will increase costs rather than lower costs."

And Robin Keith, who spoke on behalf of the Nevada Rural Hospital Partners Foundation, said it's difficult to quote prices, even for something as common as pneumonia.

That patient could need one X-ray or several, or they could use a less expensive antibiotic or a "horrendously expensive" type. They might be in intensive care or another part of the hospital.

The bill is one of several that the Assembly Health and Human Resources Committee is looking at to deal with rising hospital costs. Several other bills require hospitals to give more detail when reporting their charges to the state.