Sunday, February 10, 2008

Do you have any Coupons?


First off I want to say thank you for the kinds words about our accident, everyone is recovered now and things are finally back to normal, again thank you.



Have you ever wondered what the patient is going to be charged for those great therapy's we provide for them?

Well I have wondered that, and were I currently work the night shift RT does all respiratory charges for the day on the patients. I did a little digging and found a area in our computer system that allows me to see exactly what it costs the patient for their different therapys they have received, pretty interesting and a little fun to see how much people are up to on their bills for the stay they are currently in.

So anyways here is what I have found for prices with respiratory therapy services here at my little hospital. Also keep in mind that some of these items I am told are package deals where more than one piece of equipment is included in the cost, what a bargain right...but I will try and distinguish which ones they are. Each of the prices I am showing are only a single charge unless I state otherwise. So like a room will be per night.

First I will start with the room charges, yea I know this isn't really a RT charge but hell compare this to a hotel room and WOW, more bang for the buck in a hotel room in my opinion. No package deal here, just the room cost.

Standard Floor Room: $826.00
Intensive Care Room: $1960.00

Next I will do some standard medication prices, not to back actually but can add up.

Albuterol for Neb: $7.40
Atrovent for Neb: $7.80
Xopenex for Neb: $10.25
Mucomyst for Neb: $7.75
Advair 500/50: $348.40 This would be a full Diskus
Flovent MDI: $256.30 Full MDI

Now I will do the Respiratory Therapy service prices, somehow I think we should get a bigger cut from this, but don't we always want more pay.

Initial nebulizer treatment, includes equipment and our service: $77.25
Subsequent nebulizer treatment: $57.25
Initial nebulizer with Ezpap treatment: $295.50
Subsequent nebulizer with Ezpap treatment x 10 mins: $85.75

At my hospital we change nebs out everyday, so a QID neb orders each day would be charged for the Initial and 3 Subsequent prices. I think we change out to often but that infection control's thing.

Initial MDI treatment: $49.50
Subsequent MDI treatments: $34.25

I think that is just for services, seems pretty steep for me.

Here are our Oxygen prices, now I couldn't find prices for different O2 Equipment like cannula's and masks so I don't know about them, I'm guessing they are included in something.

Oxygen per hour: $17.25
24hr of Oxygen: $414.00
Bubble Humidifier: $11.75
Pulse oximeter check: $35.50 This is just us going in an recording a Sat!

Now lets get to some ventilator and bipap charges, this can definitly add up.

Initial Ventilator day: $1576.50
Subsequent Ventilator day: Exact Same as above

Suposedly this included all equipment, checks, oxygen, nice package deal.

Bipap per day: $167.50
Mask: $131.75
Tubing: $37.75
Headgear: $75.50
24 Hours of Bipap: $945.50

Some reason we charge for that headgear, but it comes in the same package with the mask. Someone is getting over I think.

Now just some other miscelleanous stuff:

ABG: $190.75
EKG: $195.00
Ambu Bag: $140.50
CO2 Detector: $116.25


Now just for fun lets see what a QID Albuterol and Atrovent neb would be:

Inital Neb Tx: $77.25
3 Subsequent Tx's: $57.25 x 4 = $229.00
4 Albuterols: $7.40 x 4 = $29.60
4 Atrovents: $7.80 x 4 = $31.20

Grand total of: $367.05

Yep thats our daily price for QID Albuterol and Atrovent nebs. Not even sure if we charge a sales tax or anything, I don't think so but you never know.

Well there you have it, our pricing scheme, I'm sure it' probably pretty close to most hospitals, I though it was just interesting to see.

Any of you know some of your prices it would but fun to compare prices with types and sizes of hospitals, could be interesting. I'm damn glad I have decent insurance because hospital costs can really add up. There is probably a good possibility that prices become inflated from patients with no insurance and us taxpayers cover the cost.

Just my opinion but I think if you don't have insurance and you come to the ER with something that could be taken care of at a clinic, you should have to pay something, even just $10, might make people think twice. There are too many people who take advantage of the ER and if you charge them these people might have to make a decision beween their cigarettes and beer or how bad there stuffy nose really is. You know these types and I know I'm not the only one who thinks like this.

Anyway take care everyone and thanks for reading.

Drive on RT's.

19 comments:

Jeffd said...

WOW!. As an RT that works in a publicly funded system (Canada). Those prices absolutely blow my mind. I can't ever imagine getting a bill for being treated in a hospital. An ABG costs $190, I know how much an ABG kit costs, and I know what it costs to run a ABG sample (its less than a dollar a sample) and I know how long it takes me to run an ABG and it sure doesn't add anywhere near $190!

I understand that drug pricing is hard to compare because americans pay WAY more than the rest of the world for their drugs and I'm not sure why that is.

In the province I work in, not only is almost all hospital care covered by the government even some home respiratory care things are covered too. Patients with a normal resting PaO2 <55 mmHg, are provided with home oxygen, they must purchase their own nasal cannula but the concentrator and 10 E-tanks/month are provided.

Also, patients with obstructive sleep apnea receive a CPAP or BiPAP for home use with a written prescription from a Respirologist. The patient must purchase their own mask and tubing but the machine is lent to them to use at no charge.

Providing these services may seem ridiculous in a pay for service system but management of chronic conditions prevents a lot of of people from coming into the hospital more frequently. And while it may seem that if people aren't billed for there treatment that they will just abuse it that is just not true. Many times if a patient with a minor ailment comes into ER the triage nurse will suggest that they just make an appointment with their family physician or go to a clinic, otherwise they can sit and wait for a few hours to see the ER doc. Most people take the option of going to a nearby clinic.

I have never worked in or been a patient in a fee for service system, so these prices just seem crazy to me. Especially considering this is what the patient gets charged, not what it actually costs to provide the patient care.

Thanks for sharing this info, it has been enlightening, and I look forward to sharing it with my co-workers.

Bob said...

Thanks for the great article.

Anonymous said...

That is the problem with trying to compare a single payer system to a free market system. You think our prices are high and I agree that in some cases they are but your medical costs are subsidized by tax dollars. Everyone in Canada pays for health care cost with their tax dollars regardless of how much they access the system. You pay way more in taxes although or government is doing what it can to get more from us. You also have different laws that allow an ER to send someone away for an appointment with their regular doc or deny services. No such luck here. It is illegal to turn someone away! We also cannot limit the amount of portables a home oxygen patient can have. What happens to your home oxygen patient when they use up their allotment of 10 tanks? I live in a border state and we get a lot of Canadians who come down and pay cash for medical services that they cannot get in Canada or the wait is too long. The main problem here is that those who have government paid for care have no restrictions on access. Don't get me wrong I do not want to see anyone in need get turned away but people who are on Medicaid (State financed)or Medicare (Federally financed) can access the system any time as much as they want and cannot be turned away. Having been a therapist for 20 plus years I have seen a lot of people in the ER who really need to see their regular doc at the office. The problem is the doctor's office can restrict how many Medicaid/Medicare patients they see a day and a beneficiary may have to wait and the ER cannot. So they go to the ER where they know they will get care with no concern that it is way more expensive.

Breathingthroughschool said...

Awesome post, really shows the high cost of healthcare. It would be interesting to see the wholesale cost for some of the items and see if they mark up certain things.

Anonymous said...

It is very interesting to see how concerned people are on billed price versus cost. Where do you think your pay comes from? How do you think hospitals buy all the equipment we use everyday? Look around your department, how many $20,000 ventilators are there?

Freadom said...

Awesome post. I love this so much I linked to it on my blog and went on my own tangent about it. I'm looking forward to an extended discussion.

sometimesibreathe said...

When Europe first started socialized healthcare, people were taking advantage of it. The government decided to charge something for admittace fee ~$1. It dramatically reduced admittances. I don't know why we don't implement it today.

I also started getting paranoid about dropping meds once I found out the cost of TOBI.

Djanvk said...

Wow this is a great discussion, I'm glad I could spark this. Thanks for the comments, feedback is nice.

It is really amazing on the differences of countries, Modern Countries and how health care is viewed.

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