2013 QualityCounts® Frequently Asked Questions
These Q&A will help you answer questions you may receive from your employees
Will there ever be a case where I pay a lower or higher amount than what is shown?
Yes, because the report is based on ranges. The ranges represent the high and low charges for the facility 80 percent of
the time. That means that 20 percent of the time, or 1 in 5 times, the procedure cost could be higher or lower.
As a reminder, the report reflects charges over a given period of time and is to be used as a guideline. It shows what
procedures tend to cost at different facilities, but there are no guarantees that you will be charged the price shown in
the table. Use it as a guide, not as a guarantee.
So should I always choose the lowest cost provider?
Not necessarily. Cost is just one of the factors you should use in making a decision about where to receive care. Other
factors include location, availability, quality and comfort. As a reminder, always remember to verify coverage of the
facility and coverage of the procedure with the benefit plan.
Why do costs vary?
The costs in this report are estimates based on actual cases. They are meant to give you an idea about what a typical
cost or range of costs might be. However, your case may not be exactly the same as another patient’s.
Here are some reasons why costs vary:


Physicians are all different – Two procedures may not be completed exactly the same way by different
physicians. Depending on how long a doctor takes to complete your surgery, your costs for hospital care may
be higher or lower. Also, doctors often have strong preferences in the medical supplies they use, which can
affect the cost of your surgery.
Patients are all different – No two patients are exactly alike. Procedures may change slightly based on
differences in patient age, the presence of another illness, complications during the procedure or an acute
condition at the time of the procedure.
Does higher cost mean higher quality? Should I go to the higher cost provider because they
will provide better care?
What you pay is not related to the quality of your care. A higher cost provider does not necessarily have higher quality or
do the procedure any differently than a low cost provider.
How can providers charge so much?
Because consumers have been insulated from the charges of health care, providers have been allowed to charge what
they want for procedures. By being more informed and asking questions about your care, you can help understand your
costs better and let providers know that cost does matter.
So which should I use, the median or the range?
The median is the best predictor of what you will pay.
The median shows the middle point between all costs, which means that half the patients who used the particular
facility were charged lower amounts and half were charged higher amounts. In the report, the median is also often the
“mode,” which is the most common occurrence.
The report uses median instead of averages because averages, which are calculated by adding up all the costs and
dividing that amount by the total number of costs, can be skewed if there are a few cases where there were very high or
low costs.
As a reminder, the report reflects charges over a given period of time and is to be used as a guideline. It shows what
procedures tend to cost at different facilities, but there are no guarantees that you will be charged the price shown in
the table. Use it as a guide, not as a guarantee.
What if I find out that a certain procedure is less at a different hospital than the one my doctor
has suggested? How do I find a doctor who performs the procedure at a different hospital that
may provide the same procedure at a lower cost?
Call the hospital you are interested in having the procedure at and ask them for the names of doctors who have
privileges to perform the procedure there.
Next take that list of doctors and compare it with The Alliance provider directory at the-alliance.org/find_doctor to be
sure they are in your network. Finally, you may want to speak with your original doctor to see if he/she knows any of
those doctors and if he/she would recommend one of them.