And the proof is in the pudding. Yes, virtually all Port Townsend physicians work for the hospital. Are costs higher here? You bet. Lots. Now a study by UC Berkeley shows it’s more than just us.
If a local hospital recently bought your physician’s practice, chances are the costs of your treatment will go up.
The intent behind hospital/physician consolidation was to achieve better coordination and care for patients. However, some experts think consolidation reduces competition, resulting in higher prices.
This article does a good job of highlighting why we pay more at Jefferson Healthcare, even though it’s a publically owned hospital. We are designated a “critical access” hospital, meaning we are rural, which gives JHC much greater flexibility of charging. JHC and Port Townsend are in a strange situation, in that we are designated the same as a very remote hospital, say in Eastern Washington, or Forks. Though we are only a short drive from non-rural designated systems in Poulsbo or Seattle. The take away is that unless you can afford to pay more for your care, or weigh the cost and hassle of traveling, you will pay less (sometimes significantly less) for the same care by going to Seattle or even in some cases, Poulsbo. I’ve personally found it to be dramatically less, especially for procedures and labs. If you can, always shop your medical care. Jefferson Healthcare is in the process of evaluating their charges, based on customer complaints. The unintended consequence of all this is that the poor and lower income people pay a much higher percent of their income for healthcare by living here and not shopping their healthcare. They often don’t have the time to do so, and often aren’t even aware of the problem in pricing.
Medicare patients’ out-of-pocket costs for outpatient care are significantly higher at critical access hospitals than at other acute care hospitals, and the reason for the difference in cost is buried in a 1997 law.
This was sent out by the Jefferson Healthcare on their concerns to changes to the 340B program. This program has been used to theoretically fund low cost prescriptions. There are a variety of points of view about what the program has actually achieved, but the hospital is adamantly opposed to the cuts to it. We likely can discuss this more at the next Citizen’s Healthcare Access group meeting in September in Port Townsend.
340b letter PDF file. Here’s the first page so you can decide if you want to read the whole PDF.
Good short article detailing the problems facing independent medical practitioners today. This is the state of medicine we are in. Jennifer Hanscom is the CEO and executive director of the Washington State Medical Association.
When I began my career at the Washington State Medical Association in 1996, 38 percent of physicians were in solo practice; today that number has plummeted to less than four percent. For comparison, during that same period only 18 percent of physicians were in practices of 100 or more physicians and a good percent of those practices were large independent clinics. Today, over 61 percent of physicians practice in groups of more than 100 physicians, with most employed by integrated systems.
Jefferson Healthcare continues to struggle to provide patients with transparent pricing. This article from 2017 touches on the issues and benefits of providing patients with transparent pricing.