MD Anderson's charges

[sarah]

I was saddened to read about this. I thought MD Anderson was a non-profit hospital but.....

http://healthland.time.com/2013/02/2...ticle-mostpop1
1. Routine Care, Unforgettable Bills
When Sean Recchi, a 42-year-old from Lancaster, Ohio, was told last March that he had non-Hodgkin’s lymphoma, his wife Stephanie knew she had to get him to MD Anderson Cancer Center in Houston. Stephanie’s father had been treated there 10 years earlier, and she and her family credited the doctors and nurses at MD Anderson with extending his life by at least eight years.
Because Stephanie and her husband had recently started their own small technology business, they were unable to buy comprehensive health insurance. For $469 a month, or about 20% of their income, they had been able to get only a policy that covered just $2,000 per day of any hospital costs. “We don’t take that kind of discount insurance,” said the woman at MD Anderson when Stephanie called to make an appointment for Sean.
Stephanie was then told by a billing clerk that the estimated cost of Sean’s visit — just to be examined for six days so a treatment plan could be devised — would be $48,900, due in advance. Stephanie got her mother to write her a check. “You do anything you can in a situation like that,” she says. The Recchis flew to Houston, leaving Stephanie’s mother to care for their two teenage children.
About a week later, Stephanie had to ask her mother for $35,000 more so Sean could begin the treatment the doctors had decided was urgent. His condition had worsened rapidly since he had arrived in Houston. He was “sweating and shaking with chills and pains,” Stephanie recalls. “He had a large mass in his chest that was … growing. He was panicked.”
Nonetheless, Sean was held for about 90 minutes in a reception area, she says, because the hospital could not confirm that the check had cleared. Sean was allowed to see the doctor only after he advanced MD Anderson $7,500 from his credit card. The hospital says there was nothing unusual about how Sean was kept waiting. According to MD Anderson communications manager Julie Penne, “Asking for advance payment for services is a common, if unfortunate, situation that confronts hospitals all over the United States.”

Claudia Susana for TIME
Sean Recchi
Diagnosed with non-Hodgkin’s lymphoma at age 42. Total cost, in advance, for Sean’s treatment plan and initial doses of chemotherapy: $83,900. Charges for blood and lab tests amounted to more than $15,000; with Medicare, they would have cost a few hundred dollars


The total cost, in advance, for Sean to get his treatment plan and initial doses of chemotherapy was $83,900.
Why?
The first of the 344 lines printed out across eight pages of his hospital bill — filled with indecipherable numerical codes and acronyms — seemed innocuous. But it set the tone for all that followed. It read, “1 ACETAMINOPHE TABS 325 MG.” The charge was only $1.50, but it was for a generic version of a Tylenol pill. You can buy 100 of them on Amazon for $1.49 even without a hospital’s purchasing power.
(In-Depth Video: The Exorbitant Prices of Health Care)
Dozens of midpriced items were embedded with similarly aggressive markups, like $283.00 for a “CHEST, PA AND LAT 71020.” That’s a simple chest X-ray, for which MD Anderson is routinely paid $20.44 when it treats a patient on Medicare, the government health care program for the elderly.
Every time a nurse drew blood, a “ROUTINE VENIPUNCTURE” charge of $36.00 appeared, accompanied by charges of $23 to $78 for each of a dozen or more lab analyses performed on the blood sample. In all, the charges for blood and other lab tests done on Recchi amounted to more than $15,000. Had Recchi been old enough for Medicare, MD Anderson would have been paid a few hundred dollars for all those tests. By law, Medicare’s payments approximate a hospital’s cost of providing a service, including overhead, equipment and salaries.
On the second page of the bill, the markups got bolder. Recchi was charged $13,702 for “1 RITUXIMAB INJ 660 MG.” That’s an injection of 660 mg of a cancer wonder drug called Rituxan. The average price paid by all hospitals for this dose is about $4,000, but MD Anderson probably gets a volume discount that would make its cost $3,000 to $3,500. That means the nonprofit cancer center’s paid-in-advance markup on Recchi’s lifesaving shot would be about 400%.
When I asked MD Anderson to comment on the charges on Recchi’s bill, the cancer center released a written statement that said in part, “The issues related to health care finance are complex for patients, health care providers, payers and government entities alike … MD Anderson’s clinical billing and collection practices are similar to those of other major hospitals and academic medical centers.”
The hospital’s hard-nosed approach pays off. Although it is officially a nonprofit unit of the University of Texas, MD Anderson has revenue that exceeds the cost of the world-class care it provides by so much that its operating profit for the fiscal year 2010, the most recent annual report it filed with the U.S. Department of Health and Human Services, was $531 million. That’s a profit margin of 26% on revenue of $2.05 billion, an astounding result for such a service-intensive enterprise.1
The president of MD Anderson is paid like someone running a prosperous business. Ronald DePinho’s total compensation last year was $1,845,000. That does not count outside earnings derived from a much publicized waiver he received from the university that, according to the Houston Chronicle, allows him to maintain unspecified “financial ties with his three principal pharmaceutical companies.”
(SHARE YOUR THOUGHTS: Are Medical Bills Too High? Tell Us Here)
DePinho’s salary is nearly two and a half times the $750,000 paid to Francisco Cigarroa, the chancellor of entire University of Texas system, of which MD Anderson is a part. This pay structure is emblematic of American medical economics and is reflected on campuses across the U.S., where the president of a hospital or hospital system associated with a university — whether it’s Texas, Stanford, Duke or Yale — is invariably paid much more than the person in charge of the university.
I got the idea for this article when I was visiting Rice University last year. As I was leaving the campus, which is just outside the central business district of Houston, I noticed a group of glass skyscrapers about a mile away lighting up the evening sky. The scene looked like Dubai. I was looking at the Texas Medical Center, a nearly 1,300-acre, 280-building complex of hospitals and related medical facilities, of which MD Anderson is the lead brand name. Medicine had obviously become a huge business. In fact, of Houston’s top 10 employers, five are hospitals, including MD Anderson with 19,000 employees; three, led by ExxonMobil with 14,000 employees, are energy companies. How did that happen, I wondered. Where’s all that money coming from? And where is it going? I have spent the past seven months trying to find out by analyzing a variety of bills from hospitals like MD Anderson, doctors, drug companies and every other player in the American health care ecosystem.
When you look behind the bills that Sean Recchi and other patients receive, you see nothing rational — no rhyme or reason — about the costs they faced in a marketplace they enter through no choice of their own. The only constant is the sticker shock for the patients who are asked to pay.

Read more: http://healthland.time.com/2013/02/2...#ixzz2MqDIGLOo

[CoolBreeze]

Tens of thousands of cancer patients are successfully treated at places other than MD Anderson.

Nobody has to go there, and they have a right to make money, I think. This doesn't bother me.

[jaykay]

This was part of an in-depth piece on healthcare in the U.S. in Time magazine. It's not just MD Anderson, it's many other hospitals.

I do agree they have the right to make a profit but if you have the opportunity to read the entire article, the charges for things like generic Tylenol, blood draws, etc. are jaw-dropping especially when you consider what gets paid under contract from insurance companies and Medicaid/Medicare.

I am lucky to have wonderful healthcare coverage from work, but it is scary to think what I would do without it.

Janis

['lizbeth]

I am bothered by this, ouch. It puts cutting edge treatment beyond the reach of many patients. I feel that family's pain and distress.

What kind of society are we - if the cost of health care is so exorbitant? If the attitude is: well go elsewhere. Is the best treatment just for the wealthiest? The entitled? The lucky?

Personally I'm in the lucky category. My care has been stellar. I have amazing doctors and they've been indulgent about treatments, tests, etc. I got upset over an invoice and the hospital stopped sending them, just covered everything. But I remember receiving a $20,000 statement and the insurance rep told me I was going to be responsible for the entire amount. I sobbed for days. I felt responsible for the financial ruin of my family because I had cancer. It was devastating.

My sister-in-laws chemo was $600,000 and they had to pay 25%. Refinanced the house, then almost lost it. These stories are repeated over and over in millions of families in the US.

Ann, I'm disagreeing with you and I hope you can take a second look. I don't agree with the go elsewhere. It meant a lot to the wife to be at MD Anderson. Those costs of treatment are just exorbitant, and the way the payment was handled makes me cringe. The cost of care is spiraling upward, out of control. To me it is indicative of the entire medical system. When do the providers step back and say we need to scale back on the costs, that we have been affected by greed, and grandiosity? That we have lost sight of our purpose - which is to keep people healthy and well. Should the average family be financially devastated?

Ann, I hope you don't feel I'm picking on you. But I've managed too many companies and in this case profit seems to be affecting values. When a person's life is at stake - and they are truly vulnerable, we, society needs to protect the weak. Extracting healthy profits from the desperate, the dying. How does this speak of us?

I'm not saying to give the care away. But in the US we should be able to have a more compassionate, affordable system that gives equal opportunity to each patient for care.

[jaykay]

this is the url to the entire article:

http://healthland.time.com/2013/02/2...d=hl-main-belt

[Lauriesh]

I agree with Ann. This family chose to go there, knowing that they did not take their insurance. I am sure there are several good clinics in ohio that they could have went to. Saying " that it meant a lot for the wife to go there" because her dad went there is not a really compelling reason to go there.

I am in mn, and I m sure there are some people who would love to go to Mayo for treatment, but can't because of ins/ expenses etc. If someone chooses to go there knowing they don't take thier ins, they can't be upset when they get astronomical bills.

Laurie

[Rolepaul]

I was lucky to have good healthcare insurance, a fair amount of financial reserves, and the knowledge that only the best healthcare would save my life. MD Anderson did just that. Nina is alive and has no evidence of disease because MD Anderson was there. We had $600,000 in treatment in 2012 and paid $7500 plus travel expenses. Nina was not given 90 days and now we are looking at another 25 years of life. How much is that worth? That is something each person must ask of themselves. Nina would have been dead at Christmas 2009 without the care that happened then. What is the right amount to pay, for me it was everything, but others would second guess me.

['lizbeth]

You are very fortunate Rolepaul. If you had not been well insured with financial reserves, how tragic it would have been with only 90 days with your Nina. So happy for you for the extended years.

[Lauriesh]

I guess I don't expect sympathy from others. I am stage 4, and while I would love to go to md Anderson or sloan, I can't because my ins wouldn't cover it. I also would like to to go to the Block center in Chicago or to a naturopath , but can't because we can't afford it.
I would never ask my family to go into debt in order for me to do this either.

I go to a local onc clinic that is in network for my ins because that is what we can afford to do.

While it would be wonderful if every cancer patient could go to the top cancer treatment facility in the country, that is not realistic. I am more concerned about women who have no ins. and can't get basic coverage than those who can't go where they want because of restrictions on their ins.

Laurie

[jacqueline1102]

Hello all,

I have an interesting story to tell. The cancer care center, where I receive treatment, recently went through a rather extensive accreditation process to have MD Anderson added to the name. Check out the website: MD Anderson Community Cancer Care, Indianapolis, Indiana. Here is the interesting piece. My treatment will not change one bit. My physicians will not change one bit. The cancer care center may now have the MD Anderson label but nothing really changes. Because I work in health care I have some understanding of what this really means. Cancer care is big business and the cancer care centers are all in competition. I was told that I would have access to clinical trials perhaps more quickly but that nothing really changes.

The nurses told me that because MD Anderson is now attached to the name, patients are coming in droves within the state and in the midwest. Which is good for them. What this means for me is that my infusion times went from what used to be 3 hours max turned into 6 hours last night. I am not complaining because I am happy to have insurance through my work. And herceptin and perjeta are doing the job so far. I was just finding this a fascinating conversation.

Oh, one more thing. There are some awesome commercials and billboards now throughout the city praising the merger. I wonder how much that cost?

Hope that makes sense,

Jackie

[sarah]

Interesting discussion. I just thought that a university affiliated hospital would be less expensive.
Did you notice that the health insurance companies pay 5 times what arms dealers pay in lobbying. Why?
I just hope everyone finds a way to get the care they need to stay alive; healthcare shouldn't be a luxury. I say that as a doctor's daughter. Why does the US pay more for drugs than Canada, the UK and Europe pays? and why did the Congress make it a law that Medicare can't negotiate the prices!!! a law! Think how much Medicare could save if it could negotiate the price it pays like everywhere else in the world.
Those who lose their jobs at 55 yrs have trouble finding new jobs and keeping up with their insurance.
Maybe those of you who know of great low cost or free clinics for cancer treatment could make a list of them, that way if there are members with financial problems, they would have a solution at hand, what do you think?

[Jackie07]

More than fifteen years ago, the mother of two sisters (and their families) in our church was told by our local hospital (a big general hospital with over 500 beds) I've used for over 20 years that she'd only had six months to live due to stage 4 lung cancer. Her children took her to MD Anderson (for a consult?) and then received treatment in the local hospital following the advice they'd received from MD Anderson.

She lived more than 4 years past the original 'expiration' day given by the oncologist in our local hospital.

With Internet and other telecommunication devices, it seems that all cancer patients can receive good treatment locally (except expensive equitment such as Gamma-knife which my hospital had a contract with a GKRS center less than 150 miles away when I had my GKRS in 2001)

Being a world leader in cancer treatment, MD Anderson has to put in certain policy/prodedure to deal with the hundreds/thousands of requests/referrals they're receiving everyday.

[evergreen]

I am so relieved to live in Canada. With our health insurance paid for by everyone's taxes, no-one need worry about being denied care because of financial issues. Of course we pay for it with our taxes, but just like house insurance, everyone shares the cost so that those who need support, will get it. Whether you are employed or not. No matter your age, address, economic status, marital status, or medical history. Sure, we have some waits for some non-urgent surgeries. But that means operating rooms are available to give timely service to folks such as myself, with an aggressive cancer. I urge you to support the U.S. move to what you call "Obamacare".

[sassy]

Here is a link to our resources page that lists some possible sources of financial assistance.

http://her2support.org/resources/financial-legal

[sarah]

Great Sassy. I hope this is also a special page people can find easily.
Like Evergreen, I'm glad I live where cost doesn't enter the picture (France). We pay a social tax that covers everyone, even visitors who fall ill while in the country. The French are extremely proud of their system and having had to test it out personally for cancer and heart problems, it seems great to me.
MD Anderson certainly seems to do a great job and is at the forefront of health. I hope they do open their doors also to some of those who can't avoid them.

[sassy]

Just click on tHe link,
Or copy and paste the line into your address bar,
Or go to our home page and you will find the listing for Resources across the top listings on the page. Select the drop down to see financial resources.

[sarah]

Thanks Sassy. great to know. Obviously I don't need it where I live but I know it could be useful to people in the States so thanks for this.
stay well
sarah