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What You Need to Know to Find Affordable Health Care Services
How do you search for health care prices?
How Much Does an Appendectomy Cost?
How Much Does a CT Scan Cost?
Online tools to look up hospitals and doctors
Looking for Health Care Prices, But Cannot Find Them
Do You Know Your Out-of-Pocket Costs
Medical Tourism as an Option to Reduce Health Care Costs
Difference Between Negotiated Price and List Price
A Perfect Healthcare System
Wanted: True prices for health care services
How Much Will This Service Cost Me?
Get a Better Deal on Health Care Services
Find Out Treatment Costs Before Services are Provided
AOL Provides Tips on How to Cut Your Health-Care Costs
Were you overcharged for health care services?
Are You Being Overcharged for Medical Care? Here are some tips on how you can fight back
Make Smarter Decisions about Health Care Providers
What's New at OutofPocket.com
Checking into a Hospital? Be sure to check out these tips first
Consumers Driving Health Care
Shopping Around for a Low-Cost MRI
New Years Resolution: Ask your provider for a cash discount
Lively discussions on transparency at the AHIP conference in Chicago

Archive

November, 2008 (1)
October, 2008 (11)
September, 2008 (8)
August, 2008 (1)
July, 2008 (1)
June, 2008 (2)
May, 2008 (3)
April, 2008 (2)
March, 2008 (3)
February, 2008 (2)
January, 2008 (2)
December, 2007 (2)
November, 2007 (1)
October, 2007 (3)
September, 2007 (3)

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The opinions expressed herein are my own personal opinions and do not represent my employer's view in any way.

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Total Posts: 46
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 Monday, November 17, 2008
What You Need to Know to Find Affordable Health Care Services
Monday, November 17, 2008 1:45:28 PM (Central Standard Time, UTC-06:00) ( Finding the Best Value for Health Care Services | Transparency )

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?

 

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 Services Coronary Bypass Hip Replacement Pneumonia
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 $40,486 n/a n/a
Boston Medical Center $33,988 n/a n/a
Beth Israel Deaconess Medical Center $43,514 $21,627 $6,389
Lahey Clinic $43,857 $20,175 $6,127
Northeast Health System, Beverly Hospital n/a $18,299 $5,695
South Shore Hospital n/a n/a $6,311
Brockton Hospital n/a n/a $5,052
Winchester Hospital n/a n/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 $838 n/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 $513 n/a
Northeast Health System, Beverly Hospital n/a $504 $148
South Shore Hospital $835 $519 $163
Brockton Hospital $590 $443 $139
Winchester Hospital $716 $537 $168

 

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 Friday, October 31, 2008
How do you search for health care prices?
Friday, October 31, 2008 3:05:17 PM (Central Standard Time, UTC-06:00) ( Consumer-driven health care | Finding the Best Value for Health Care Services | High deductible Health Insurance | Transparency )

If you have a health insurance deductible to satisfy, or if you are enrolled in a consumer driven healthcare plan, or if you have out-of-pocket costs that add up to more than $25/visit, I am sure you try to make the most of your health care dollars by finding low-cost providers that offer  the best value.  How do you find these low-cost providers?

 

Starting November 1st, I am polling the community to find out how you search for health care prices.  I am interested in understanding how different consumers search for low-cost healthcare prices. What tools do you use to compare prices for health care services?  What “search terms” do you type in Google to find prices for health care services?

 

Let’s assume you visited your doctor and you need to have a non-emergency test or procedure performed.   How do you go about your search to compare prices for services like MRIs, x-rays, mammograms, vaccinations, lab tests, or a colonoscopy?  Do you ask your doctor for estimated prices?  Do you call the hospital or facility and ask for prices?  Do you ask your family, friends or neighbor to compare what they paid?  Do you call your health insurance hot-line for prices and recommendation on where to get the best value for this service?  Do you use Google to search?  If so, what search terms do you use? 

 

Send me an email to let me know what search terms you would use (or have used) to look-up and compare health care prices for specific services.   The first 1,000 people to respond will be entered in a drawing for a chance to win a $50 Amazon.com gift certificate.  Email entries will be accepted through November 30, 2008.

 

Here are the details to be included in the drawing for the $50 Amazon gift card.  Send an email to info@OutofPocket.com  and in your email message be sure to include:

 

(1)   What specific resources you would use (search engines, websites, online tools)

(2)   What search terms you would use to find prices for health care services

(3)   An email address where we can contact you, to notify you if you win the drawing

 

Good luck and thanks for sharing your search tips with us. 

 

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 Thursday, October 30, 2008
How Much Does an Appendectomy Cost?
Thursday, October 30, 2008 7:54:06 PM (Central Standard Time, UTC-06:00) ( Consumer-driven health care | Finding the Best Value for Health Care Services | Transparency )
Here's the scoop on the true price of an appendectomy.

If you are wondering what the true cost of an appendectomy is, keep reading....  Jaz-Michael King’s blog, A Scanner Brightly, provides the most thorough detail I have ever read on a patient’s charges for an appendectomy.  He wrote this blog earlier this year, and itemized the specific charges related to his appendectomy procedure.  A huge thank you to Jaz-Michael for sharing this detail with everyone to help us become better health care consumers.  I am glad everything turned out fine for Jaz-Michael and I would like to encourage him to keep up the great blog.  The data he shares is a wealth of information for consumers.

You definitely should read his blog entry, Hospital Bill: Appendix Ultimatum - it includes his comments and other useful information on the breakdown of costs for this procedure. 

 

Here are the itemized charges for an emergency appendectomy.

 

Appendectomy -- Itemized Charges

Charges

Actual Negotiated Price

Emergency Room:

$1,185.00

$419.68

Emergency Room Physician:

$1,461

$460.60

Cat Scan:

$2,015.00

$713.64

Operating Room:

$3,250.00

1,151.03

Surgeon:

$1,740.00

$626.81

Anesthetist:

$1,601.00

$787.50

Recovery Room:

$3,100.00

$1,097.91

Pathologist:

$35.00

$35.00

Semi-Private Ward:

$5,000.00

$1,770.81

X-Ray:

$127.00

$44.98

Per Diems:

$5,850.70

$5,850.70

Labs, Supplies, Medical Services

$1,627.04

$652.65

 

 

 

New York State Service Charge

$523.64

$523.64

 

 

 

Total Hospital Charges:

$22,718.70

 

Total Paid:

$12,078.38

 

 

 

 

 

 

 

The hospital visit was reimbursed at 53.2% of charges

 

Insurance: CIGNA

 

 

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 Tuesday, October 28, 2008
How Much Does a CT Scan Cost?
Tuesday, October 28, 2008 9:14:08 AM (Central Standard Time, UTC-06:00) ( Finding the Best Value for Health Care Services | Transparency )
Are you shopping around for a CT scan but have no idea how much your out-of-pocket costs will be? You are not alone. A new type of CT scan, called “virtual colonoscopy”, offers a noninvasive and less expensive alternative than the traditional CAT scan.

A virtual colonoscopy test can cost anywhere from $500 to $1,500, depending on where you go to have the test done. Another reason to consider a virtual colonoscopy test – it is half the cost of a standard colonoscopy. Before you make any decisions, make sure you check with your insurance plan to see if the virtual test is covered for routine cancer screening.

Wall Street Journal published a story on CT Scans and included some price comparisons at different facilities. If you have insurance or are paying cash, make sure you talk with the billing department before you have the test done, to understand your out-of-pocket costs for your specific situation.

Hospital or Clinic

Location

Price

Invision Sally Jobe

Denver, CO

$800

Johns Hopkins Hospital

Baltimore, MD

$1,000

M.D. Anderson Cancer Center

Houston, TX

$1,500

Virginia Commonwealth University Medical Center

Richmond, VA

$750

Mayo Clinic

Rochester, NY

Scottsdale, AZ

$1,400-$1,500

Ronald Regan UCLA Hospital

Los Angeles, CA

$505

University of Chicago Hospital

Chicago, Il

$1,153

University of Wisconsin Hospital

Madison, WI

$1,200

Beth Israel Deaconess Medical Center

Boston, MA

$1,017

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 Sunday, October 26, 2008
Online tools to look up hospitals and doctors
Sunday, October 26, 2008 4:59:36 PM (Central Standard Time, UTC-06:00) ( Transparency )

Finding the best value for health care is not just about finding the lowest cost provider.  Value has everything to do with price and quality.  Today it’s very difficult for consumers to find useful and meaningful information on doctors.  To help you make informed health care choices, I’ve identified four online tools to help you do your homework ---before choosing a hospital or medical professional for your surgery, procedure or treatment.

 

Quality Check

 

This tool provides hospital performance reports with information by medical specialty. The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) obtains information about accredited organizations not only through direct observations by its employees, but also through direct communications from those accredited organizations and from measurement companies hired by accredited organizations and accepted by The Joint Commission as sources for performance measure data. 

 

Hospital Compare

 

This Government online tool on the U.S. Department of Health & Human Services website provides information on how well hospitals care for patients with certain medical conditions or surgical procedures, and the results from a survey of patients about the quality of care patients received durin