How Much Does a Hip Replacement Cost?

How Much Does a Hip Replacement Cost?

Answer:  “It depends…”

When I started practicing law, the treatment of medical bills in a personal injury case was pretty straightforward.  This was before the implementation of statutory cost containment controls like we now have in motor vehicle cases, workers’ compensation, etc.  It was also a time when large health insurers, such as the Blues, didn’t have the clout they have now.  The charges for medical services in a given community tended to be uniform from hospital to hospital, and provider to provider.  The bill would typically be paid in full.  At trial, we would prepare an exhibit listing all of the charges and identifying the provider and the type of treatment rendered.  The plaintiff’s treating physician would testify that the charges represented the reasonable value of the services, and that was it.

How times have changed.  In the first place, there is now no uniformity among providers and hospitals as far as list prices for medical services. This was brought home recently in a study by the University of Iowa published in JAMA Internal Medicine.  Hospitals throughout the country, including the top 20 ranked orthopaedic hospitals, were contacted by a person who said that she was calling on behalf of her 62 year old grandmother who did not have health insurance but was able to pay for a hip replacement out of pocket.  The caller requested the lowest “complete” price, meaning hospital plus physician fees, for an elective total hip replacement.  The caller was able to obtain price information from most of the hospitals.  The estimates ranged from $12,500.00 to $125,798.00, a factor of 10 to 1!

Trial lawyers have been aware of this phenomenon for years.  Previous studies have looked at the cost of routine tests such as x-rays and CAT scans and found cost differences similar to the University of Iowa study.  Perhaps this is not surprising, since now almost nobody pays list price for medical services.  The price depends on who is doing the paying.   The only people likely to pay list price are those like the hypothetical uninsured Iowa grandmother.  I would love to see our legislatures do something about this.  Perhaps hospitals and other health care providers could be required to post their list prices for common procedures.   At least then there would be some transparency, and those folks who do not have insurance or who have inadequate insurance, can at least do some meaningful price shopping.

By:  Edward E. Houseman, Esquire, attorney for the Reading, Pennsylvania personal injury law firm of Liever, Hyman & Potter which limits their practice to medical malpractice, car, truck and motorcycle accidents, premises liability, nursing home neglect, and work injuries. Serving Berks, Schuylkill, and surrounding counties for over 50 years.

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