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What You Need to Know to Find Affordable Health Care Services

Posted Apr 06 2009 11:15pm

How much does an MRI of the brain cost?  What would I pay for a CT-scan?  What provider offers the best price for an ultrasound?


Every week you shop for goods/services, and make choices based on what is a “good value.”   When you make these purchase decisions, you use the skills you have (without even thinking about it) to find the best value.   The same rules apply when you are trying to make the most of your healthcare dollars.    It doesn’t matter if you are shopping for prescription medications, durable medical equipment, providers, diagnostic tests or vaccinations.   Obviously in an emergency situation these rules do not apply, but for routine service you need to put on your consumer hat and apply some simple rules.   If you do not follow these rules, you will end up overpaying for services.    Our healthcare system charges consumers up to 300% more for the exact same service and if you aren’t informed there’s a good change you will overpay.   Would you rather spend less on healthcare and more on family vacations?

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Three things you need to remember when shopping for health care services:

Shop around.   Apply your consumer-savvy skills to comparison shop and find out what other consumers paid for similar services.   Providers charge hundreds of different prices for the exact same service.   Make sure you find the best price and get the best value.   Talk to other consumers and find out where people went for services and what they thought of the provider.   Were the prices fair?   

Ask lots of questions.   Don’t be afraid to ask providers and your insurance plan questions like “how much will this service cost me? “   Ask friends, family, community groups where they would go to get the best value for a specific service/treatment. Information can be powerful.

Use resources available.   Make the most of tools available to you via websites, insurance plans, health content sites, community sites and blogs.   If your health insurance plan provides cost estimator tools, be sure to check these out. They are not always meaningful, but worth looking into.   The more you know, the better informed you will be.   For me the most effective way to get actual prices is to call the insurance plan and the provider directly and ask them how much this service will cost me.   You can also use websites that provide pricing to understand what others paid for similar services.   Most importantly, don’t be afraid to ask for a price and if necessary, as for a discount.

The Boston Globe Spotlight Team reported on a story about pricing discrepancies in our healthcare system.   They obtained actual private insurance data in their research to analyze provider prices for the exact same service and compared these prices with providers in Massachusetts.   Here’s a summary of what they found:

InPatient ServicesCoronary BypassHip ReplacementPneumonia
Average price in Massachusetts$43,514$19,256$5,695
Massachusetts General Hospital$51,522$23,197$6,789
Brighan and Women's Hospital$47,138$24,552$7,936
Tufts Medical Center$40,486n/an/a
Boston Medical Center$33,988n/an/a
Beth Israel Deaconess Medical Center$43,514$21,627$6,389
Lahey Clinic$43,857$20,175$6,127
Northeast Health System, Beverly Hospitaln/a$18,299$5,695
South Shore Hospitaln/an/a$6,311
Brockton Hospitaln/an/a$5,052
Winchester Hospitaln/an/a$4,814
OutPatient Services  MRI of Brain    CT Scan of Chest    Ultrasound, 1st trimester  
Average price in Massachusetts$693$482$129
Massachusetts General Hospital$1,153$838n/a
Brighan and Women's Hospital$1,118$838$263
Tufts Medical Center$638$478$117
Boston Medical Center$557$418$86
Beth Israel Deaconess Medical Center$855$642$201
Lahey Clinic$704$513n/a
Northeast Health System, Beverly Hospitaln/a$504$148
South Shore Hospital$835$519$163
Brockton Hospital$590$443$139
Winchester Hospital$716$537$168


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