Shop around for surgery? Negotiating health care costs to save cash

If you want to get the best deal for your next medical procedure, be prepared to negotiate.

You probably heard this week that the federal government released new data about just how dramatically the cost of identical medical procedures can vary from hospital to hospital. Tens of thousands of dollars in some cases. So what should you, as a consumer, do make of this information?

"There's a lot of room for consumers to shop around to different hospitals and to negotiate with hospitals to get a better value for their money," says Dr. Jeffrey Rice, CEO of Healthcare Blue Book -- a free price comparison Web site.

"You might pay $1,200 for a colonoscopy at one facility and you might pay $4,000 or more at another facility," says Rice. "And by just calling ahead before you get your care and asking the facility and your provider how much it's going to be under your own insurance plan, or if you're a self-pay, under a self-pay discount, you can find out exactly how much you're going to pay and get a much better value from the healthcare system."

But how feasible is it for someone to shop around for different health care options, especially if they're sick and in need of medical attention quickly?

In an emergency situation, Rice says you obviously don't have the same opportunity to be a health care comparison shopper. "But the vast majority of health care that Americans use, is not an emergency," he says.

Still, he admits that some procedures are easier to shop around for than others. "It's typically really easy to shop for outpatient procedures, most independent facilities can give you a specific price and they'll stand by that commitment," says Rice. "It's a little more difficult when you're dealing with larger inpatient facilities and inpatient services.  Typically, they'll give you an estimate, but they won't commit to that estimate, so it can be much more difficult to shop for the inpatient services, even if it's not an emergency."

But if you limit your options according to price, couldn't you also jeopardize the quality of your care? How can a consumer take both into account before making decisions?

Rice says his company, Healthcare Blue Book, makes it easy for patients to look up the fair price of procedures -- and it's free. "Then, when you call and check with your providers on their price, you'll know whether it's a reasonable price or not," says Rice. As for health care quality, he recommends looking at physicians' board certifications, malpractice history and any special training they might have. And to find out about facilities, he suggests visiting the government's Center for Medicaid and Medicare Service website, which includes quality metrics for inpatient care.

"The good news for patients," says Rice, "is that typically, the lower price providers have as good or better quality than the higher cost providers, and there's study after study showing that."

No matter who you're going to see though, Rice stresses that it's important look into cost before receiving care. "You wouldn't go buy a car without knowing the price or a house without knowing the price," he says. "If you're not in an emergency situation, it's absolutely the patient's right to know how much their care is going to cost them before they get treated."

Sometimes this can mean having to call several healthcare providers and insurance agents -- who aren't exactly known for their transparency. But Rice says it's worth the effort. "When thousands of dollars are at stake, and -- literally -- patients can overpay by $3000, $5000, $10,000 or more, on a lot of surgeries, for example, it's worth the time to make those phone calls and then check with your providers, " he says.

About the author

In more than 20 years in public radio, Barbara Bogaev has served as the longtime guest host of NPR’s flagship program Fresh Air with Terry Gross, as well as host of APM’s news and culture magazine, Weekend America and the weekly national documentary series, Soundprint.

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