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Shopping Around for the Best Prices for Various Healthcare Services

Posted Dec 01 2009 10:04pm

One of the most innovative features of walk-in retail clinics, located in chain pharmacy and big-box stores, is that they frequently post their price lists for the services they provide. This is rare for providers of healthcare services but may mark the beginning of a trend. A recent article in the New York Times provided guidance for consumers who are price-sensitive or believe that healthcare services should be exposed to market competitive forces. Below is an excerpt from this article (see: (see: Seeking the Best Medical Care Prices ):

Health care consumers are encouraged to comparison-shop on things like doctor’s fees and heart surgery rates. But unfortunately, most of us have little clear or useful information to go shopping with....An estimated 15 percent of adults younger than 65 now pay with their own money medical costs greater than 5 percent of their annual household income....So the typical person is probably far more motivated to ask how much an M.R.I. or a hip replacement costs.....The crucial part of shopping wisely for health care (or anything else for that matter) is comparing prices ....But that is also where problems arise. Medical pricing is a quagmire....What’s more, rarely is there one standard price for a medical treatment. Prices vary based on geography and type of provider....Then, doctors, hospitals and other providers may negotiate different rates with different insurers. It is not unusual for a provider to have 10 or more different prices for the same procedure, depending on who is paying....Many insurance companies have begun posting provider prices on their Web sites so enrollees can access cost information. These tools allow you to compare prices among network doctors (not all network doctors are paid the same) and check on the price of diagnostic tests and other treatments....A few Web companies have tried to fill the price information gap online, all with varying approaches.On PriceDoc.com,...you plug in your ZIP code to find a list of providers in your area who have posted their prices. You can also plug in the price you’re willing to pay. Providers will then respond if they are willing to accept that price.HealthcareBlueBook.com compiles prices paid for specific treatments and procedures in ZIP codes throughout the country, then lists what the site determines is a range of fair prices....Another Web site, OutOfPocket.com, combines price information that users send in to determine a going rate for specific health care costs throughout the country....If you’re checking out hospitals, you will want to see what information your state government offers. At least 33 states mandate that hospitals make their prices public.... Often, only the most expensive, nondiscounted prices are listed.Moreover, on most sites, costs are not bundled, so you may find the price of a general surgery, for example, but it would not include the surgeon’s or anesthesiologist’s fees.

There's lots of solid advice in this article which deserves close attention by all healthcare consumers. A key fact that I have never seen before in print is the following: An estimated 15 percent of adults younger than 65 now pay with their own money medical costs greater than 5 percent of their annual household income. I understand that most insured patients may glance at bills for, say, a recent surgery and marvel at the high cost. However, their next thought is that it's the responsibility of their health insurance company to deal with it. Note the reference above to the fact that there may be "10 or more different prices for the same procedure, depending on who is paying." This is the basis for many of the problems with our healthcare system and the reason that it is often referred to as broken (see: Why the Prices Charged by Hospital for Inpatient Care Are Irrelevant ). I believe that, in the long run, the appearance of web sites such as those cited above and addressing healthcare costs will lead to a more rational healthcare pricing system. I would recommend, in the interim, that even insured patients launch a discussion with various providers about what various services may cost.

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