Anchorage Pediatricians Quietly Protest High Hospital Charge

Dr. Charles Ryan holds an infant after a circumcision. Photo by Annie Feidt, APRN - Anchorage.
Dr. Charles Ryan holds an infant after a circumcision. Photo by Annie Feidt, APRN – Anchorage.

Patients have a difficult time getting information on hospital costs. And the doctors who work in those hospitals are no different. They rarely know the hospital charges they generate for patients when they perform procedures. But last year, two of the largest pediatric groups in Anchorage discovered what Alaska Regional Hospital is charging for a simple infant procedure. And they decided to take a quiet stand against a fee they feel is unreasonably high.

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In a small room at the offices of Anchorage Pediatric Group, Doctor Charles Ryan is getting ready to circumcise a 12 day old baby.

Ryan is doing more circumcisions in the office, instead of the hospital, these days. About a year ago, he found out Alaska Regional Hospital is charging more than $2000 for the procedure. For comparison, Providence Hospital, a few miles away, charges $235.  So the doctors in Ryan’s office decided to stop doing circumcisions at Regional.

“We were, I think, shocked by the price we were hearing.”

For that $2000 fee, Regional Hospital is providing a small tray of sterilized, and reusable, instruments, a nurse to help out and a board for the infant to lay on. Ryan calls Regional’s price “wildly abnormal:”

“Health care dollars are limited and we like to see them spent in ways that really provide good health care for people and necessary health care for people and when the health care dollar is being milked off by charges that just seem out of proportion to what the cost of delivering those services is then those are dollars that can’t be used for more essential things.”

Anchorage Pediatric Group bills $700 dollars for circumcisions, wherever they perform them. It’s common for hospitals to charge a facility fee on top of what doctors charge for a procedure. Regional Hospital did not go on tape for this story. In an email, a hospital spokesperson says the cost is so high in part because the hospital has to be ready to treat minor and major medical emergencies. She also points out insurance companies, and even uninsured families, can negotiate better rates.

Still, another pediatrician in Anchorage thought it had to be a mistake when he heard the price. Dr. John Tappel works at LaTouche Pediatrics. He called the hospital twice to confirm what he was hearing:

“I… said I want to make sure we’re talking about the same thing. We aren’t accidentally including some charge that isn’t really charged to the patient or the system. And they verified that yeah, that was indeed the charge.”

Now Tappel generally avoids doing circumcisions at Regional, unless families specifically request it. Many of his colleagues have followed suit.

“It was one way that I could look at that was tangible, addressable, fixable that would in my mind at least, lower one aspect of the routine care of our patients.”

Both Tappel and Ryan emphasize they think Regional is a good hospital. And they aren’t interested in picking a fight with hospital administrators over a single fee.  Ryan says the incident highlights the fact that doctors should become better informed on hospital prices:

“Neither hospital is out there trying to put that information right in front of us. And sometimes it’s hard information to get if you ask, so that’s one of the problems is physicians aren’t aware of the costs they’re generating by the things that they’re doing.”

Tappel says hospital prices should be easier to find, but doctors have to do their part too:

“When I order that X-ray or prescribe that antibiotic, I need to do a better job of understanding how that may impact some of my families.”

This story is part of a collaboration between APRN, NPR and Kaiser Health News.















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Annie Feidt is the Managing Editor for Alaska's Energy Desk, a collaboration between Alaska Public Media in Anchorage, KTOO Public Media in Juneau and KUCB in Unalaska. Her reporting has taken her searching for polar bears on the Chukchi Sea ice, out to remote checkpoints on the Iditarod Trail, and up on the Eklutna Glacier with scientists studying its retreat. Her stories have been heard nationally on NPR and Marketplace. Annie’s career in radio journalism began in 1998 at Minnesota Public Radio, where she produced the regional edition of All Things Considered. She moved to Anchorage in 2004 with her husband, intending to stay in the 49th state just a few years. She has no plans to leave anytime soon. afeidt (at) alaskapublic (dot) org  |  907.550.8443 | About Annie