Helping the Patient Make an Informed Decision on the Cost of Care is Hard

Recently, GBMC was recognized among the 16 percent of hospitals nationwide to be fully compliant with the federal hospital price transparency rule.  

According to the semi-annual hospital transparency report by PatientRightsAdvocate.org, GBMC was one of 319 hospital websites across the country, and one of only two in Maryland, to be fully compliant with federal price transparency rules.

This law is intended to make the costs of services such as X-rays, medical tests, or procedures clear to patients before they get the service. The law requires hospitals to list the cash prices for procedures on their websites in two forms: one that is easy for patients to access and that includes a cost estimator for the 300 most common services, and another that is machine-readable — essentially a spreadsheet. All of this allows patients to know what they will be billed and lets them see how much their insurance will pay and how much they will have to pay out of pocket.

Many Americans face financial hardship because they don’t have the money to pay their medical bills. In trying to fix this, our legislators want to make people aware of the costs before they get the services. This may help with elective services, but no one is going to wait to look up prices before getting care if they have an urgent or emergent problem.

A major hurdle in trying to let the patient know what he or she will have to pay is that we literally have hundreds of insurance plans in our country, and the plans have different co-pays and deductibles. On top of that, outside of Maryland, hospitals and physician groups negotiate rates with the insurers. In Maryland, we only negotiate payment rates for physician/provider bills, but hospital prices are set by the Health Services Cost Review Commission for each hospital. 

We firmly believe that transparency is needed across the healthcare delivery system allowing patients to make more informed decisions. The patient and the insurance company should pay for value. The definition of value is health outcome + care experience.

                                                                 Cost

If hospital A provides the same outcome for a clinical procedure with the same care experience as hospital B, but the care at hospital A costs twice as much as hospital B, then it only makes sense to get care at hospital B, because hospital B will be providing twice the value of hospital A.

GBMC works tirelessly to drive the waste out of healthcare, and we are a lower cost hospital than most in our market. We are also proud to make prices more transparent for our patients. I take immense pride in knowing that we are among those at the forefront of transforming healthcare in this country and that we are among our nation's transparency leaders.

Our Great General Surgery Group
I have been reflecting recently about the excellence that we have within the GBMC HealthCare system and I want to comment on a group that does outstanding work and does not get the credit it deserves. I firmly believe that GBMC has the best general surgery group in the region.  

Our group within GBMC HealthPartners, goes by its historic name: Finney Trimble Surgical Associates, named after its founding members. The two most senior members of the group, Francis S. Rotolo, MD, FACS, division head of General Surgery at GBMC, and Laurence H. Ross, MD, are incredibly talented people who have been leaders in their field for more than 25 years. Other members of the practice include John L. Flowers, MD, who is also our healthcare system Executive Vice President and Chief Medical Officer and the leader of GBMC Health Partners; Joel A. Turner, MD, Chair of the Department of Surgery and Chief of Minimally Invasive Surgery; and Timothee J. Friesen, MD, FACS, bariatric and general surgeon and Medical Director of the GBMC Comprehensive Obesity Management Program. 

As we are celebrating Women in Medicine Month, I would also like to recognize Finney Trimble’s two fantastic female surgeons, Shauna M. Costinett, MD (left), and Emily J. Watters, MD (right), who joined the practice within the last two years. Both are board-certified general surgeons and members of our Comprehensive Obesity Management team. In a field historically dominated by men, Drs. Costinett and Watters have demonstrated their excellence since joining us, and we are delighted to have them on our team. I am also pleased to announce that a new member, Beatriz Briones, MD, a general surgeon who will practice general and bariatric surgery, will join the practice next month.  

Thank You…
On Monday, our Department of Ophthalmology hosted the 2022 Hoover/Naquin Symposium. We were honored to have Tamara Fountain, MD, delivering the Hoover Lecture, titled “Pilots and Physicians, Passengers and Patients – Maintaining Situational Awareness When Stakes Are High” and Megan E. Collins, MD, MPH, giving the Naquin Lecture, titled “Advancing Health Equity in Pediatric Eye Care.” We were pleased that Dr. Richard Hoover’s widow, Lydia, was able to be present for the lecture named in his honor. 

Dr. Fountain served as the President of the American Academy of Ophthalmology in 2021 and was named to the board of directors of the American Board of Ophthalmology in January 2022. She is a former President of the Illinois Society of Eye Physicians and Surgeons. Dr. Collins is The Allan and Claire Jensen Professor of Ophthalmology at the Johns Hopkins Wilmer Eye Institute and specializes in pediatric ophthalmology and adult strabismus. She is the Co-founder and director of the Johns Hopkins Consortium for School Based Health Solutions.

  (Standing left to right: Tamara Fountain, MD, Mary Louise
Collins, MD and Megan E. Collins, MD, MPH) 

I want to thank Drs. Fountain and Collins for participating in the lecture series and I also want to extend my appreciation to Mary Louise Collins, MD, Chairman of the Department of Ophthalmology at GBMC, and her staff for putting together such a wonderful event.