Getting the best deals in NC hospitals - WRBL

WNCN Investigates

Getting the best deals in NC hospitals

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Under a new pricing-transparency law going into effect next year, N.C. hospitals must submit charges for 140 of their most common procedures. Under a new pricing-transparency law going into effect next year, N.C. hospitals must submit charges for 140 of their most common procedures.
HOLLY SPRINGS, N.C. -

"Here I am now, almost 7 weeks out, and I can say I'm pain-free right now," Gary Kocor said from his home in Holly Springs.

Thanks to back surgery, Kocor is a new man. But he still remembers what it was like before going under the knife.

"Lower back pain for approximately a year and a half prior to that, which was sending pain radiating down both my legs," Kocor described.

When the pain got too much to bear, Kocor had a common, minimally invasive surgery -- called a "microdiscetomy" -- which removed part of a disc that was pressing on the nerves in his back. The final bill for the 90-minute procedure was around $34,000.

Based off a friend's recommendation, Kocor went to Duke Raleigh for the surgery. He still remembers seeing his bill for the first time.

"I was surprised," Kocor said. "Walking into it, I had no idea what the surgery actually cost."

But that's about to change. Under a new pricing-transparency law going into effect next year, North Carolina hospitals must submit charges for 140 of their most common procedures.

The N.C. Department of Health and Human Services' website will list them, but so far, DHHS officials say they're still in the preliminary stages of putting it all together. In the meantime, WNCN accessed a federal database that already lists prices for state-licensed hospitals in central North Carolina.

Eight include Kocor's $34,000 surgery, but the prices are all over the place.

Click here for a database comparing treatment costs at Triangle-area hospitals.

It's to the point that if Kocor went just 6 miles down the road to Rex Hospital, he could have received the same surgery for less than half the price of Duke Raleigh.

Don Dalton with the North Carolina Hospital Association cautions that a higher price doesn't necessarily mean better care. And he doesn't foresee prices going down because of the new law.

"Hospital billing is very complex because of all the people that are involved in it," Dalton said. "It's not simply someone walking in and buying a loaf of bread."

Dr. Brian Caveney with Blue Cross Blue Shield of North Carolina agrees, in part, with Dalton.

"Many of the prices are contractually bound for multi-year periods, so it will not happen overnight," Caveney said. "But it will start the conversation."

Both men recommend that in addition to talking with your current doctor, the patient should research more than just prices. That includes:

  • Looking up how many complications there are after a particular surgery.
  • Asking the hospital how many people get re-admitted within 30, 60 or 90 days after surgery.
  • Finding out how much your health insurance will cover.

"If you can look at relative quality and relative cost in two different places, you can make a good decision about where you should have your health care," Caveney said. "We want people to go to reputable databases with real quality information."

He points out that most health insurance companies, including his company, already do that on their websites. Other organizations do the same, including the N.C. Hospital Association, Consumer Reports and the Leapfrog Group.

"I went to WebMD," Gary Kocor said as he gestured toward his laptop. "Probably not the best source. But also through my health insurance company [there's] a website where they can go and they actually rank the doctor."

Kocor said he's grateful for his health insurance because he only had a $75 co-pay. But in the end, his research satisfied him -- even without knowing the price.

"At that point, it was all about me having the surgery and getting past my injury. I probably would have paid whatever he charged at that time, to be honest with you," Kocor said.

"All I can say is I'm very pleased with the results I have," Kocor added. "No pain."

Sean Maroney

Sean returns home to North Carolina after spending seven years reporting around the world and across the United States. More>>

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