Cost of Care Information

How much do hospitals charge?

Hospital charges are defined as the amount the hospital bills for the entire stay (excluding most physician fees). Charges may not reflect the actual cost of hospital care or how much is paid. Many factors influence the cost of hospital care including patient severity, technology, range of services offered, and whether the hospital is a teaching institution, and others. The average charge for a hospital stay is more than $17,300 (2002 dollars) according to the US Department of Health and Human Services. Consumers can compare Medicare & Medicaid charges and payments for Michigan hospitals at the Michigan Health and Hospital Association web site www.Mihospitalinform.com.

Who pays for hospital care?

Government (Medicare and Medicaid) is billed for 56 percent of all hospital stays; private insurance is billed for 36 percent of stays; and 5 percent of stays are uninsured. Other payer sources are billed for approximately 3 percent of all hospital stays according to the US Department of Health and Human Services.

Why is there a difference between what hospitals charge and the payments they receive?

Federal regulations require hospitals to charge all patients the same amount (with limited exeptions) for the same service. According to the Michigan Health and Hospital Association, the amount collected by the hospital is almost always less than the amount billed for three main reasons:

• Government programs, such as Medicare and Medicaid, typically pay hospitals much less than the billed charge. These payments are determined by government agencies and hospitals do not have any ability to negotiate these rates.
• Insurance companies negotiate discounts with hospitals on behalf of the patients they represent.
• Hospitals typically have policies that allow low-income persons to receive reduced-charge or free care.

How much will my hospital stay or procedure cost?

Every situation is different, and it can be difficult to predict all aspects of the care you will receive during your hospital stay, such as procedures, medications, and how the your individual condition may affect the treatment and recovery process. Therefore, our Patient Financial Services representatives will work with you individually. They can help you understand your financial obligation and payment options including insurance, co-pays, deductibles and out-of-pocket expenses. Click below for Patient Financial Services contact information.

• St. John Hospital and Medical Center
• Providence Hospital
• St. John Macomb-Oakland Hospital, Macomb Center
• St. John Macomb-Oakland Hospital, Oakland Center
• St. John North Shores Hospital
• St. John River District Hospital
• Brighton Hospital  

What if I can’t afford my care?

St. John Health has programs to assist patients who are uninsured or cannot afford medical care, including sliding scale discounts and financial assistance. Click on a hospital name below for contact information.

• St. John Hospital and Medical Center
• Providence Hospital
• St. John Macomb-Oakland Hospital, Macomb Center
• St. John Macomb-Oakland Hospital, Oakland Center
• St. John North Shores Hospital
• St. John River District Hospital
• Brighton Hospital  

Additionally, St. John Health’s Community Health programs offer a wide range of primary care services, regardless of your ability to pay. To learn more go to Community Health.

Additional Resources for Financial Assistance

The National Institutes of Health web site list of resources for financial aid for medical treatment.

How can I reduce my health care costs?

1. Reduce unforeseen costs by choosing the right  insurance plans and using providers within your health plan when possible.  Make sure you know the rules of your insurance plan before you use medical services. You can do this by reviewing your plan’s Summary of Benefits, which lists benefits and costs, and the Evidence of Coverage, which explains the rules for getting care. You can usually get copies of these from your health plan or employer.
2. Consider yourself a partner in your care and treatment. Have questions ready ahead of time to ask your doctor. Decisions about your care can account for a large portion of your medical bills. Find out your options by asking questions, such as:
   1. Is surgery or medication necessary? Why?
   2. Can my tests or surgery be done somewhere besides the hospital?
   3. What other treatments are available?
   4. What changes can I make, such as diet and exercise, to help my condition?
3. Practice preventive health:
   1. Wear a seatbelt and make sure children are using appropriate car seats and booster seats.
   2. Never drink and drive 
   3. Get rid of safety hazards at home and at work 
   4. Keep guns locked up 
   5. Install smoke detectors and fire extinguishers 
   6. Wear sunscreen 
   7. Follow a healthy diet 
   8. Exercise regularly 
   9. Get regular health screenings and checkups