Imagine you're rushed into an emergency room with a heart problem. The doctor says you need an electrocardiogram to check your heartbeat. You ask about the price — and no one can give it to you.
Turns out you might end up paying anywhere between $18 and $317 for the test, depending on the hospital and your insurance. And if you happen to be uninsured or a minority patient, you're more likely to end up getting dinged with a higher hospital bill.
Welcome to the arcane and arbitrary world of billing practices at US hospitals today, as detailed in a new JAMA Internal Medicine study. The researchers, from the Johns Hopkins School of Public Health, uncovered wild variation in the charging practices of hospital emergency rooms, and found that vulnerable patients — uninsured people, minority groups — are more likely to be hit with the highest bills.
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These charging practices aren't the result of evil schemes on the part of hospital billing departments. Instead, they're set by hospital "chargemasters" — computer software that adjusts the prices for hospital services with the goal of hitting certain profit targets. The prices are based on expected collection rates, and tend to fluctuate day to day. They're also pretty random, the researchers found, but trend toward minorities and the uninsured getting gouged the most.