{"id":284,"date":"2015-04-06T16:42:35","date_gmt":"2015-04-06T16:42:35","guid":{"rendered":"http:\/\/stories.kera.org\/broken-hip\/?page_id=284"},"modified":"2015-12-30T20:51:21","modified_gmt":"2015-12-30T20:51:21","slug":"the-cost-of-a-broken-hip","status":"publish","type":"page","link":"https:\/\/stories.kera.org\/the-broken-hip\/the-cost-of-a-broken-hip\/","title":{"rendered":"The Cost of a Broken Hip"},"content":{"rendered":"

Finding out the price of a new car or a new phone isn\u2019t so hard. But how about the price of a new hip? The cost of medical procedures like hip replacements can vary by thousands of dollars \u2013 even tens of thousands of dollars.<\/em><\/p>\n

We talked with Sean Cavanaugh, deputy director of the federal government\u2019s Center of Medicare, about who\u2019s paying what and why.<\/em><\/p>\n

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Breaking down the costs<\/h4>\n

Hospital bills are high \u2013 but Medicare patients don\u2019t foot the entire bill. Actually, a lot is left unpaid.<\/em><\/p>\n

Question: <\/strong>Two years ago the average hip replacement in Texas cost about $48,000 \u2013 that was the average hospital charge. Medicare only paid about $9,000 of that and patients were responsible for $1,300. What do you make of that discrepancy?<\/p>\n

Sean Cavanaugh: <\/strong>“Hospital charges are often very disconnected from what Medicare and other payers are actually paying hospitals. I think the people who need to worry about hospital charges are those who go in with either no insurance or the type of insurance that requires significant deductibles because then they are often subject to charges.”<\/p>\n

\"Sean

Sean Cavanaugh is deputy director of the federal government\u2019s Center of Medicare. Credit: College of American Pathologists\/Flickr<\/p><\/div>\n

After the hip replacement<\/h4>\n

The sticker price for a new hip doesn\u2019t tell the whole story. Much of the cost — and what makes the bill so difficult to predict — comes after a patient leaves the hospital.<\/em><\/p>\n

Question: <\/strong>Is there any way to determine how much a Medicare beneficiary can expect to pay for something like a hip replacement?<\/p>\n

Cavanaugh:<\/strong> “It\u2019s complicated. A patient can probably get a pretty good sense of what they\u2019ll owe for the hospital portion of their stay, what the hospital likely will be paid. And they also know in Medicare benefits what their hospital deductible is, which is around $1,200. That\u2019s the easy part.<\/p>\n

\"An

An X-ray of a hip replacement. Credit: Shutterstock<\/p><\/div>\n

“Where it gets more complicated is that patient will also be seen by physicians and he or she doesn\u2019t know how often those physician visits will occur, but the patient will be liable for the deductible and the cost sharing associated with physician visits.<\/p>\n

“Where it grows increasingly complex is the course of treatment the patient receives after they\u2019re discharged from the hospital. A hip fracture is a perfectly good example. A patient with a hip fracture could be discharged to home but more typically these patients would be discharged to an inpatient rehabilitation facility. They could be discharged to a skilled nursing facility. They could be discharged to home but with home physical therapy.<\/p>\n

“In each of those cases, Medicare appraises providers differently and the patient has different cost-sharing responsibilities.”<\/p>\n