Comparison shop for that colonoscopy

Marketplace Staff May 4, 2007

Comparison shop for that colonoscopy

Marketplace Staff May 4, 2007

TESS VIGELAND: If you’ve ever tried to read a hospital bill, you probably ended up back in the ER with an ulcer: 50 bucks for a bandaid, 20 grand for an I.V.

Well this week, the insurance company Anthem Blue Cross announced it’s expanding a pilot program that allows patients to shop for the best deal on, say, a gallbladder removal.

It’s another development in what’s been dubbed consumer-driven health care.

Helen Palmer reports from the Health Desk at WGBH on whether it can really make a difference in our hospital bills.

HELEN PALMER: You’d think Consumers Union – publisher of that bible of best values, Consumer Reports – would cheer the availability of health price data.

But Consumers’ Union’s Bill Vaughan says most of the information out there’s confusing. Vaughan says you should first turn to your state for answers.

BILL VAUGHN: There’s 30 states that have passed one kind of law or another requiring disclosure of pricing information.

California and Florida do a particularly good job, because they give comparisons on both cost and quality. They post hospital death rates, for example. Wisconsin pioneered Pricepoint, a program so clear and easy to use that nine other states have adopted it. Insurance companies are also posting prices. First out of the gate was Aetna.

Chief medical officer Troy Brennan:

TROY BRENNAN: Well, the prices are the prices we directly negotiate with the individual providers. So things like how much an office visit costs and simple procedures that are done within the office, such as test for blood in stool, rapid strep tests.

The medical director for Anthem Blue Cross says its website’s unique, because it can tell you the total cost for a more complicated procedure – like a colonoscopy. It does this by lumping together the doctor’s cost, facility cost, anesthesiologist – even the medicines you’ll take.

So members can really compare prices, says Anthem’s Barry Malinowski.

BARRY MALINOWSKI: You have to put in your member ID number . . .

PALMER: And it goes from miniumum agreed price of $699 to a maximum agreed price of $977 at the low end. And if you go down to the high end, you have a minimum agreed price of $2,796, compared with a maximum of $3,075.

MALINOWSKI: You can figure that probably the cost of your procedure to you from a co-pay standpoint is gonna to be 20 percent of $699 or 20 percent of $977.

Or of course, 20 percent of $2,700 if you choose a more expensive facility.

Malinowski says Anthem first tested the system in Dayton, Ohio, with General Motors.

GM’s Sam Shalaby thinks it’s great for employees.

SAM SHALABY: Better care at lower prices. Ultimately they would get healthier, and that will have an impact on their quality of life and on their productivity.

It’s not just states and insurance companies that are trying to be transparent. Hospital’s getting in on the act. Hospital company HCA offers what it calls “true out-of-pocket costs for both insured and uninsured patients.” There are also websites, like HealthGrades and the newly-launched Revolution Health, that let consumers research cost and quality. HealthGrades charges a small fee.

Linda Perla, an executive assistant in Manhattan, paid $8 to check out credentials of plastic surgeons – and get a good price for a nose job.

LINDA PERLA: I’ll say I got maybe, like, $700 off.

Perla says she felt confident – she’d done her research and was able to use that research to bargain. And ultimately, that’s the whole idea behind posting health care prices – that as empowered consumers, we will take control.

In Boston, I’m Helen Palmer for Marketplace Money.

There’s a lot happening in the world.  Through it all, Marketplace is here for you. 

You rely on Marketplace to break down the world’s events and tell you how it affects you in a fact-based, approachable way. We rely on your financial support to keep making that possible. 

Your donation today powers the independent journalism that you rely on. For just $5/month, you can help sustain Marketplace so we can keep reporting on the things that matter to you.