- Board Member Ron Drummond draws on his background in hospital billing and shares a process he uses for getting a better price on his health care. Also read this month’s Member Spotlight for more information about Ron and his wife, Lynn. Ron also explains why the Drummonds joined Samaritan.
- Rob Slane reflects on similarities he sees between Donald Trump’s election as U.S. president and the referendum in Britain to leave the European Union. He says in both countries there has been an attempt to usher in a “Kingdom of Love” without depending on God.
- Dr. David Brownstein’s book, The Statin Disaster, is reviewed on page 6. He cites evidence that statin medications are a failure at treating heart disease and are associated with a host of dangerous conditions. He also explains how he has successfully treated heart disease with nutritional and hormone therapies.
- Health care expert Devon Herrick explains why health care costs a lot more than it should. He shows how the industry uses government regulation to deny patients money-saving health care options.
- The Doorpost points to how verses 11 and 12 work together in Matthew 7.
By Ron Drummond, Board Member
As a Samaritan Ministries member, you’re a cash-pay patient. If you previously had health insurance, that means you need to learn a different way of navigating the health care world.
When my wife, Lynn, and I joined Samaritan, I started putting my experience as a hospital billing and patient account auditor to work. I’d like to share what I discovered, in the hope that you’ll find something to help you.
First, I started gathering information on direct primary care practices, even before there was one available in our area. Every month I searched the direct pay sites for a local DPC physician, and one month there finally was one.
Direct Primary Care was a significant change for my wife, but after we interviewed the doctor, she was on board. Now we have a doctor working for us, not a third party, with whom we can discuss price and quality.
We find the DPC membership to be well worth it for the unlimited access to the doctor, and it also results in savings on services our DPC can provide or connect us to. Our DPC doctor has found us hundreds of dollars in savings on imaging services, prescriptions, and routine procedures.
Over time I have developed a process for finding health care at the best price.
- For outpatient and orthopedic surgeries, I go to the Surgery Center of Oklahoma website (surgerycenterok.com) and use their pricing tool to find out what the true cash price would be.
- I also use Healthcare Bluebook (healthcarebluebook.com) and search for the price of a procedure in my ZIP code. Healthcare Bluebook then provides me with what the hospital would receive if I had insurance. This is good gauge of the “retail price.”
- I open a search using Medibid (which members can access inside the Samaritan Dashboard) to see if any local cash providers would be lower than the Healthcare Bluebook price.
- Finally, I have been calling hospitals in my area to see what their price estimate would be for a procedure, telling them that I do not have insurance and also asking what their cash discount percentage would be.
I followed this process in 2015 when I needed a routine outpatient procedure. I was able to get the procedure, originally priced at over $31,000 at the highest priced hospital, performed locally for $5,300 after discounts.
Shortly after this need, I decided to call all the hospitals in Kansas City and capture their cash-pay discounts in a spreadsheet. It was an eye-opening experience as I documented discounts as low as 25 percent and all the way up to 75 percent. I also was able to get some information about average prices from a consulting company, so the spreadsheet shows the effect of average prices combined with the cash-pay discount and ultimately the best value for the Samaritan members that will be sharing in our burden.
Knowing ahead of time what a hospital’s cash discount is allows you to have a more honest conversation with the folks in registration. I tell them I am a cash-pay patient and ask them to confirm that their cash discount is X percent. They usually don’t have a script for someone who says they are cash-pay, so then we can have a conversation about how I will be paying the bill.
Some providers are very receptive to cash-pay patients, seeing them as a new market, and some are not. We are certainly seeing it in Kansas City, where three different health systems offer cash discounts of 70 percent or more for cash payers.
Because of the fallout from the Affordable Care Act—plans with high deductibles and other out-of-pocket costs—hospitals are actually having to learn more how to deal with cash payment from many of their patients.
In fact, hospitals are seeing patients presenting at registration and claiming to have no insurance, when they actually have a high-deductible plan, because the word on the street is that if you tell the hospital you have no insurance, you’re potentially going to get a better price. If you tell the hospital you have a high-deductible plan they won’t give you a cash-pay discount and you’re going to wind up owing a big dollar amount for your deductible.
In general, the more progressive organizations and the organizations that face a lot of competition in their markets are more open and receptive to larger cash discounts. Smaller markets, not so much.
Keep in mind that in the hospital industry, those who are “self-pay” are often viewed as the population that doesn’t pay their bills. That’s why it’s a good idea to start by presenting yourself as a “cash-pay” patient.
I encourage Samaritan members to shop around for good health care prices and discounts, and, if possible, to do it before medical care is needed. That was something Lynn asked me to do before we joined Samaritan, because she wanted to be sure where we would go and how we would pay in the case of an emergency.
It was a good exercise to go through. At first we were concerned about how we were going to handle payment to providers. Now we are both very comfortable being part of the Samaritan family.
Ron Drummond is a member of the Samaritan Ministries Board of Directors and also is an auditor for hospital billing and patient accounts systems. He lives with his wife, Lynn, near Kansas City.
By Rob Slane
I am writing this piece a couple of days after the confirmation of Donald J. Trump’s election to the office of president of the United States of America. Unlike the mainstream media, I was not surprised by this result. Having already witnessed firsthand the quiet but determined revolt against the cultural leaders in the Brexit vote, and seeing many of the same sorts of issues present in the United States, I expected that there would be another major shock. If Brexit was the First Blast of the Trumpet Against the Monstrous Regiment of Global Elites, the U.S. presidential election was the Second.
One of my favorite tweets on election night came from Nobel Prize winning economist and New York Times columnist, Paul Krugman:
“A terrifying night, and not just because Trump might win. It turns out that there is a deeper rage in white, rural America than I knew.”
Krugman had no clue of the frustration many ordinary people throughout the country have with the whole political system and with the direction the country is moving. Why didn’t he know? Because he, along with the rest of the cultural commentators, is out of touch with ordinary citizens.
Will these cultural elites learn a lesson? Yes, but it may well be a wrong one, amply demonstrated by Mr. Krugman again in a couple of later tweets on the same evening:
Ron Drummond wants his insights into the hospital industry to be helpful for Samaritan Ministries members.
A member since 2012, Ron was elected to the Samaritan Board of Directors in 2015. He brings years of experience working with hospital charging and billing systems. Ron hopes he can help Samaritan to help its members find better prices for health care in an environment of continually rising costs.
“The biggest problem consumers face when seeking care is there is no standard price for anything and patients normally don’t have any way to understand what prices are before they show up at a doctor’s office for a procedure,” he says. “Most processes for charging are dictated by insurance coding. Prices vary substantially from hospital to hospital and region to region, even within the same region. It’s pretty much the wild, wild West.”
Ron didn’t set out to work as a consultant or auditor in hospitals’ accounting systems. His first job was working in a hospital laboratory in Canton, Illinois. After he and his wife, Lynn, wound up in Waterloo, Iowa, he decided to earn an accounting degree from the University of Northern Iowa, becoming a certified public accountant in 1992. In 1996 Ron took a job with Cerner Corp., the second largest electronic hospital records company in the U.S., as a support specialist working with their laboratory software product. In 1999, Ron began working with the software that is used to capture charges that are billable to patients.
When Ron Drummond left the corporate world in 2012 after 16 years to become an independent consultant, he also left the “safety” of health insurance.
“We needed something,” he says.
He knew about Samaritan Ministries from Dick Chatterton, a friend of his from the Drummonds’ days in the Canton, Illinois, area. The Drummonds and Chattertons had both attended Calvary Baptist, and Dick would tell Ron about how Samaritan enables Christians to help each other with health care burdens.
Later, Ron created a website for Dick’s restored tractor business.
As part of his research before joining Samaritan, he discovered “all the back-office stuff that happens” between insurance companies and medical providers, “the difference between what you’re charged and what the health insurance company actually pays.”
The result: “The more I looked into Samaritan, the more comfortable I became with the concept and the process.”