Using cash to pay for medical procedures could save Oklahomans hundreds to thousands of dollars. Thanks to a recent state law, it can count toward your deductible too.
James Cash, a retired Tulsa surgeon who helped pass the law last year, said when he took his physician’s oath to do no harm, that included financial. The former orthopedic surgeon created a website, PriceofCare.com, to make shopping for prices easier.
The website tells you the cash prices for about 100 of the most common medical tests, procedures and exams at 15 Tulsa hospitals. Sometimes, the cash price is cheaper than what you’d pay with insurance or the charged price.
Cash said many people don’t know there’s a cash option which could “save money, improve access and prevent bankruptcy.”
“Information is becoming more accessible, it’s different than it was five years ago,” Cash said. “Laws have been passed. They’re in favor of the consumer now.”
Every hospital in the nation is required to publicly post its prices. Oftentimes, they’re hidden in thousands of lines and codes. Many of them have cost estimators of their own, which tend to be more user-friendly.
Why hospital policies vary
For example, at Tulsa’s Saint Francis Hospital, an ankle MRI would cost $5,086, per the hospital’s estimator tool. That drops to $2,034 if someone paid with cash. At Oklahoma Surgical Hospital, it would cost $400.
“Just because it’s the lowest doesn’t mean it’s the lowest quality because quality and cost aren’t correlated in health care,” Cash said. He acknowledged his website may be inaccurate if a facility has outdated pricing or none at all. The tool includes steps on how to access that information.
If you do have insurance, your options to pay with cash might be limited — though, depending on your plan, you may not have to pay much to begin with. St. Francis has a policy requiring patients with insurance to use it or pay the full charge since cash pay discounts are mostly for people without insurance. Medicare and Medicaid patients may also face challenges if they want to pay in cash.
Saint Francis CEO Cliff Robertson said this policy exists because of their contracts with insurance companies. They have it to make paying “consistent and simple.”
“We’re not opposed to cash-paying patients. It’s just we’re also trying to navigate a very complicated set of rules,” Robertson said.
The Tulsa Flyer reached out to Hillcrest Hospital and Ascension St. John Medical Center about whether they also have a policy like this and did not hear back.
Why insurance prices are high
Insurance companies negotiate prices with health care facilities, which are usually cheaper than the price the health care facility charges. But insurance companies are capped at spending 80% of the money they get on premiums and health care costs. That means the remaining 20% has to cover overhead and administrative costs.
Cash argues this incentivizes insurance companies to raise their prices. When people can’t afford care or insurance doesn’t pay, that also makes things more expensive, Robertson said.
“In the ideal world, we would love nothing more than to have everybody be paying cash, where we could simplify our side of the organization, of the transaction,” he said.
But not everyone can afford to pay out of pocket — and in most states, these payments don’t count toward your deductible. Though, that’s no longer the case here or in Texas and Tennessee.
Cash said one of his next goals is ensuring people can submit claims with ease to insurance companies for cash pay pricing. He’d also like to expand the capacity and scope of his website to other regions like Oklahoma City.
“I don’t want people not to make a profit, but make a reasonable profit,” Cash said. “Don’t make an unreasonable profit on the backs of people going bankrupt.”
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