Thursday, January 19, 2017

It's Time to Address the High Cost of Care

It's Time to Address the High Cost of Care
High Fees, Out of Network ER Doctors Raise Your Out of Pocket Costs

For years, patients have been paying high fees at Sutter Coast Hospital, along with inflated charges to the hospital's "out of network" ER doctors.  It's time for the high fees to end.

Sutter Health has received national attention for its high patient care charges. See this NY Times article on the inflated charges at Sutter's hospital in San Francisco: 

As a first step in addressing local healthcare costs, I am compiling a list of fees for common procedures at local clinics and Sutter Coast Hospital.  Thus far, Sutter Coast has not provided any of the data I requested on their fees. However, using data from bills provided by patients, Sutter's charges are much higher than other facilities--up to 10 times higher for lab tests compared to the reference lab on 1771 Northcrest Blvd.  Colonscopy charges are roughly three times higher at Sutter Coast compared to Medford, OR.  MRI scans at Sutter are roughly double the cost of the same study in surrounding communities.  

In Crescent City, in addition to Sutter's fees, we have another problem:  The contract Sutter Coast signed with its ER physicians allows the doctors to charge patients "out of network" rates, as was confirmed last week by Sutter Coast Hospital administrator Carlos Priestly.  Please see the 12/29/16 article by Jessica Cejnar in The Del Norte Triplicate for more details: 
Those of you who have received treatment at the Sutter Coast Hospital ER know the shock of seeing huge doctor bills.  To add to the injustice, there is no sign in the ER notifying patients they will be charged higher, out of network rates--you find out when your bill arrives.

Sutter Coast administrator Carlos Priestly claims that the hospital treatment consent form addresses the out of network ER issue.  But I read the hospital's consent form--it makes no mention of EmCare (the corporation which hires Sutter Coast's ER doctors), nor does it disclose the fact that the ER doctors are "out of network," or the actual charges which patients incur.  Sutter Coast administration knows its ER doctors are out of network, but are not disclosing that fact to patients.  As a first step, I asked Mr. Priestly to post a sign in the ER, notifying patients that the doctors are out of network.

Other Highlights from the last Healthcare District meeting:
  • Sutter Coast Hospital administrator Carlos Priestly confirmed the hospital does not have sufficient staff to utilize all its beds, which means patients are either held in the emergency room or transferred to another hospital. Mr. Priestly said Sutter Coast is working to address its staff shortages.
  • Mr. Priestly confirmed the census at Sutter Coast has been consistently over 25 patients.  Remember 25 is the acute care bed limit for Critical Access hospitals, and that in 2013, the hospital Board voted (over my dissenting vote) to downsize Sutter Coast to Critical Access.  Thanks to community opposition, the hospital Board later reversed its decision to implement Critical Access, which would have tripled out of pocket costs to local Medicare patients and increased the number of patient transfers to outside hospitals.  But we must stay alert--hospital CEO Mitch Hanna has publicly stated, "we are not closing the door" [on Critical Access].
How You Can Help:

If you would like to end Sutter's high charges and out of network doctors, here is how you can help:

1.  Write our local newspaper, asking the Sutter Coast Hospital Board of Directors, and hospital CEO Mitch Hanna, to put an end to ER physicians charging inflated, out of network rates.  Ask Sutter to publicly post its charges for common tests and procedures.  Letters to The Del Norte Triplicate may be mailed to 312 H. St., P.O. Box 277, Crescent City, CA  95531 

2.  Review your hospital or clinic bill:  contact me at (707) 465-1126 or by email.  I will confidentially review your charges, including "out of network" doctor fees.

Disclaimer:  This publication reflects my personal views and is not representative of my roles as a member of the Del Norte Healthcare District Board, or as Chief of Surgery at Sutter Coast Hospital.

Gregory J. Duncan, M.D. | | (707) 465-1126
Diplomate, American Board of Orthopedic Surgery
Finally, please accept heartfelt thanks from Dr. Kevin Caldwell and me for supporting us in our recent election to the Del Norte Healthcare District Board.  Your votes energized our commitment to expanded, improved healthcare for residents and visitors to our region.  We look forward to working with you!

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