A revised report presented to the Legislative Health and Human Services Committee shows prices for hospital procedures depend on who is paying the tab. The report shows that uninsured patients paying out of pocket often have the highest rates.
The report says there are usually four different prices for any particular medical billing code. There's the gross or list charge – think of that as the manufacturer’s sticker price on a car. Then there are the two negotiated rates for private insurance or for those on public assistance, and finally the discounted cash price for uninsured patients.
Dr. Fred Hyde, who authored the report for the New Mexico Center on Law and Poverty, told lawmakers this week the system hurts our most vulnerable neighbors.
"The higher prices may be labeled 'cash discounts' or 'self-pay discounts' or other kinds of discounts, but they’re generally higher," Hyde said.
At about 30 New Mexico hospitals, insurance companies paid an average of $968 for a CT scan of the head, but uninsured patients were billed about $1,300 on average. The list price for the CT scan averaged $1,868.
Troy Clark from the New Mexico Hospital Association said hospitals try to help indigent patients get government aid, but those who are not eligible and do not have insurance are charged the cash price.
The Center on Law and Poverty told lawmakers that even after recent legislative actions there is still not sufficient data available to show how public dollars are helping with uninsured patients’ bills.
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This report is part of our Your New Mexico Government project, a collaboration between KUNM radio and New Mexico PBS. Support for public media provided by the Thornburg Foundation.
