Advocates for lower cost health care have for some time argued that arming consumers with data about the costs of medical procedures would help drive down prices.
Insurers, however, have kept a tight lid on what they pay doctors and other health care providers, arguing that such information is proprietary and disclosure would put them at a competitive disadvantage.
But now a bevy of new Web sites can help consumers learn just how much services costs, reports the Wall Street Journal (subscription required). The sites cull information from a variety of resources, including insurers, government agencies, Internet companies and health-care providers.
The sites, nearly two dozen of them, aren't perfect, the Journal notes, but they can provide a rough idea of typical costs in your area.
One example the Journal article notes is of a funeral-home operator in Kentucky. Looking to learn how much a local hospital would charge for his wife's gastrointestinal surgery, John Rogers turned to HealthcareBlueBook.com after a hospital told him its facility fee would run $4,200. The free Web site suggested a more reasonable price would be $1,300, based on data culled from insurance company payments.
Armed with the information, Rogers, who is uninsured, found an outplacement surgery center that would charge $900. His wife's doctor agreed to do the surgery there. Like many consumers, Rogers feels that he shouldn't have to pay more than insurers do. Without the aid of Web-based research tools, however, uncovering how much payment insurers received was impossible.
At the source of growing consumer interest in negotiating better prices for health care is the exploding cost of health care itself. Among the procedures the Journal notes consumers are most interested in checking prices on are CT scans, MRIs, colonoscopies and mammograms.
Even those with health insurance are interested in learning more about how much is being charged. That's because as costs have risen, so has the amount covered health-care consumers are contributing to deductibles and co-pays.
Citing data from the Kaiser Family Foundation, the newspaper reports the average family deductible for an employer preferred-provider-organization plan was $1,488, up from $1,034 in 2006. Further, more than half of workers now pay a percentage of the cost of hospital fees and outpatient surgery, instead of a flat fee.
Still, finding the information you are looking for can take some digging and checking of multiple sites. And cost isn't the only consideration to take into account when shopping for health care; quality counts, too. Web sites such as Medicare's HospitalCompare.hhs.gov and LeapfrogGroup.org can help with that issue.
Patients with insurance can also check with their insurers, a number of which now provide pricing tools. They include WellPoint, UnitedHealth, Humana, Aetna and Cigna. States, too, increasingly are jumping on the bandwagon. Among those now offering tools are Maine, Oregon, Massachusetts and New Hampshire, the Journal notes, and more states are in the process of building such databases.
Among other sites consumers can turn to: Changehealthcare.com; NewChoiceHealth.com; PriceDoc.com and OutOfPocket.com.
Of course, not everyone is interested in doing the virtual legwork it takes to uncover local reasonable and customary charges for medical procedures. But with sunlight finally shining on some of these costs, consumers looking to get the best medical care for their health dollars at least have many more tools at their disposal.
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