INDIANAPOLIS — Studies show the average Hoosier spends anywhere between 10 to 20 percent of their income on healthcare, and new rules aim to force a drop in the high cost of that care.
CBS4 delved into Indiana’s high medical costs, talking to people on both sides of the issue who agree that current costs are too high.
Hairstylist and small business owner Carrie Harris sees the reality of those costs. Harris battled breast cancer and still undergoes yearly monitoring while having to purchase health insurance on her own through the marketplace.
“I pay thousands a year out of pocket,” Harris said. “$500 a month for health insurance with (an) almost $5,500 deductible, I think is a lot.”
Harris recently shared her story with Hoosiers for Affordable Healthcare. The group, formed two years ago, has lobbied state lawmakers to try to drive down costs.
“Employers had said, ‘Listen, we’re at a breaking point. We have to stop and do something different,'” said Chief Policy Strategist Matt Bell.
Yet CBS4 found disagreement, and even competing studies, regarding how Indiana stacks up against the rest of the country, as well as the reasons for rising healthcare costs. Depending on who you ask, hospital consolidation, lack of competition among insurance companies, and Indiana’s poor health metrics are all cited as contributing factors.
“We found that Indiana has the fourth highest hospital prices in the nation, higher than any state in the Midwest,” Bell said.
Indiana Hospital Association President Brian Tabor disagreed with Bell’s assessment.
“Indiana is really right in the middle when it comes to costs,” Tabor said. “The idea that Indiana is some type of outlier is just not true.”
Tabor did agree, though, that hospital costs in particular need to go down.
“If we could all commit to working together, then I think that we could absolutely bend the cost curve,” Tabor said.
On each side of the issue, the focus has increasingly turned to transparency. A new federal rule, established on January 1, requires hospitals to post pricing information online and offer consumer-friendly “shoppable” services.
Central Indiana’s five big hospital systems, IU Health, Ascension St. Vincent, Community Health Network, Franciscan Health, and Eskenazi Health, have all established their own online price estimator tool in recent years, along with options to request a detailed estimate prior to a procedure.
CBS4 used those tools to look up the cost of a routine colonoscopy at all five providers, without insurance and found estimates varied by as much as $3,000. When you factor in your insurance plan, that cost could vary even more.
“A lot of it really just depends on how that insurance company has negotiated with hospital A versus hospital B over the years,” Tabor said.
Indiana is also currently building an all-payer claims database, where insurance companies will be required to divulge costs in order to provide more data for cost comparisons. Plus, state legislators just passed a new law that requires non-profit hospital systems and insurers to conduct annual community meetings with the public.
“When folks have to be accountable at the local level, talk about efforts they’ve made to lower prices, we believe action will follow,” Bell said.
Carrie Harris knows how quickly the high cost of care can hit home, as evidenced by a recent accident in which she broke her wrist.
“I still had to pay like $3,400 for my surgery,” Harris said. “You spend a lot of time figuring out what you’re paying for.”
The idea of shopping for a procedure like that surgery may seem far-fetched, but Bell believes that we are headed in that direction and that as more data becomes available, one-stop websites will pop up that make it easier to compare costs.
“One of the changes that we’re going to have to see is a change in consumer behavior,” Bell said.
The Indiana Hospital Association already runs a website called My Care INsight, which you can visit at the link here, that allows you to compare costs and quality between providers.
You should also contact your insurance company for a more accurate estimate of out-of-pocket costs. For more information about pricing transparency and to request your own cost estimate, visit the links below for central Indiana’s largest providers: