Why are Ablations so Expensive?

[MaryLL]

I just had an ablation and thank goodness for health insurance. The bills submitted for my procedure were $91,000 plus for 20 hours in the hospital.
Is this normal? It just freaks me out because it seems outrageous. I feel great, but are healthcare costs this far out of control?
Yikes...
Appreciate others sharing their costs. Out of pocket is $3,000, so not bad overall. but again, yikes!
MaryLL

[Jerry_NJ]

I don't have any specific information on Ablation, but some cost variation would be common.  For example Ablation in the left side of the heart, usually needed to treat Atrial Fibrillation, would is much more complex than Ablation in the right side, especially the right ventricle.  Thus, there price would be different, I believe.  You didn't specify how much of the 20 hours in the hospital were devoted to the Ablation procedure... but the more time that takes, the more it costs.

It is also common for the price paid by an insurance plan, or by Medicare, is much lower than the "list" price.  All this said/speculated, I'd say $91K sounds a bit high, but again I wonder if that much was finally paid.

[cindy707]

Mary i think you got the deal of the century here....91K for an ablation is pretty cheap i think....i had mine a couple of years ago in Northern California or Marin County and mine was in the mid 100K range but i also had a few complications during the procedure and i am assuming when you say 20 hours that you like myself decided to spend the nite in the hospital which i did and was released the next day.  I had great insurance also it was Blue Cross and they covered ALOT of it and i think my share of cost was about 3800.00 but i am so not complaining....my life is worth alot more than $160,000. that they charged here but California is one of the most expensive states in the U.S, to live in and we pay for that privilige ten fold even tho my family has lived here for 8 generations and that is why so many people work 2 jobs if you want to live well.  Healthcare costs in themselves are really not out of control it is the inanimate expenses that are bad....look at your itemized bill and i bet your doc wasn't paid that much in comparison to the cost of the hospital and equipment and meds, etc. thats where its a little crazy...i know that 2 motrin for a headache i got afterwards was 24.00 that the hospital charged my insurance...Mary i think we may have missed the bus on that one and are in the wrong business.....but again what are out lives worth?  Glad you are doing great......

[MaryLL]

Thanks for the responses. Yes, Jerry, I my procedure took 10 hours on the left atria and they only did 95% of it due to a complication with an abnormality in the pulmonary vein. I may have to have it again to finish the other 5% plus the right atria, but we are hoping 95% covered enough to make a difference. I'm feeling good and hopeful.

It helped to hear your feedback. I don't have to pay it, but I do worry about others without healthcare and our whole crisis. The cardiologists didn't get so much of it, mostly technology and hospital.

I am grateful to have been able to get this done and to feel better. In just 3 short weeks, I have much more energy, less fatigue, and am losing weight quickly and healthily.

I appreciate this board so much and the way people share their hopes, experiences, and truths. It has strengthened me and I hope to be there for others in the coming weeks as you have been for me.

Happy Summer!
MaryLL

[itdood]

Dang, I remember when my father had his heart TRANSPLANT back in 1988, it cost $110,000 total.  I tought holy crap that's a lot of money.

Oddly enough I think ablations take longer and my be more complex than a transplant.  His transplant took 5 hours.  I hear ablations taking 9 hours sometimes.

I wonder what insurance paid, did you see that portion?  more than likely it was less than $91k.  that's just insane.

I'm wondeirng how much of that goes to mal-practice insurance both for the hosp and the doc.  I bet it's like somewhere in the range of 30-40%.  Gotta keep those lawyers and plantiffs happy too, they are such a key part of healthcare  /sarcasm  :-p

[Jerry_NJ]

Right, I had open heart surgery for a mitral valve repair (reason for the surgery) and a mini-maze to cure the AFib  (this part didn't work).   I don't recall what I was told, but I think I was in surgery for 5-6 hours.  I was put under in the afternoon and was enjoying the breathing tub remove in the early evening.  It has all been too long for me to remember much and that's probably a good thing.

I think the 2007 "rack rate" with 5 days in Intensive Care must have been in the neighborhood of $150K, but I think far less was paid.  I know I paid a small amount, I had already hit all my deductibles by the time the surgery was done.  I'm sure a lot goes for insurance, now there's a place we could all benefit from if the congress could pass a health care law that actually lowers cost, that helps us patients.

[chuparosa]

This post made me want to cry. I have been saving almost this whole year, working 2 jobs, to save for my ablation. My ep study was over 3k with insurance. I had no idea how expensive this procedure would be. I think I may have greatly underestimated what my costs will be. I feel like giving up.....

[Jerry_NJ]

You mention insurance, that will help I think. In all my experience with health insurance, now United Health Care, these providers have what is called "in network" facilities and doctors.  When I had open heart surgery I found both a surgeon and a heart hospital that were in-network.  With my coverage that meant my out-of-pocket was limited to a maximum specified in my coverage.  The in-network arrangement also specified the insurance company negotiated amount that would be paid... an amount much less than the "list price".  

[cindy707]

I was in the same boat Chuparosa and went on a payment plan for my share of cost...i think i paid 200.00 a month and then the hospital sent me a form that they can give you that they write off your debt.......i did it and was sooooo happy i didn't have that hanging over my head.....i figure all of the taxes i paid in my life i should get something back and that was it....at 24.00 for two motrin i didn't feel bad believe me.....

[hosehead]

Jerry,

I too have AF.  Just started on Amiodarone (anti Arrythmic) and will be cardioverted in 1 week.  I wanted to go right to Electro catheter ablasion but Cardiologist said lets try this first.  My question to you though is....since you had open heart where they were able to go right to the source of the afib (outside left atria) and it still didn't work?  What could the drs could have possibly said to you, about the failure, that kept you from putting a curse on them?   FYI - I believe at DHMC in Hanover, RFA is less than $40,000, is same day procedure and can take up to 8 hours.  
Take care.
Todd

[chuparosa]

Great tip Cindy! I had not even considered a payment plan. That could be the exact thing I may need. Thanks, that perked me up a lot.

[Jerry_NJ]

No to steal this post, but it seems "chuparosa" has gotten some helpful input from Cindy, so I'll replay to you question about my experience.

I was given a 60% chance of the mini-maze being effective.  Unlike an ablation it is not targeted on specific signal paths known to be giving unwanted/needed beat signals.  It is a "maze" a pattern of cuts.  I think it has better odds if one doesn't have an enlarged left atrium, I do and that's why they opened me up.. to fix the mitral valve which was allowing high ventricle pressure to be passed back into the left atrium.  Even with targeting, an Ablation is not a sure thing.  I think odds as good as 90% are quoted, but not in my case, again because of the enlarged left atrium.  I  think I was given a number like 70% for Ablation and was told my symptoms are not serious enough to take the associated risk. I can relate to that as the 60% shot didn't pay off... well I was in NSR for about a month, long enough to give me a real "heart break" when I went back into AFib.  Still, I really don't feel "too" bad, the fatigue I feel is the biggest problem and I think that is due to the beta blocker which I hope to reduce further in favor of higher dose calcium channel blocker meds.

Again, my apologies to chuparosa for using her post... I hope the information is of at least some interest/benefit.