Americans may be more worried about the costs of a major illness than about the illness itself, writes Jeanne Pinder in the summer issue of the Journal of American Physicians and Surgeons. Prices for various procedures can vary by a factor of 20 or more. Pinder describes an award-winning project, ClearHealthCosts.com, that she and fellow journalists undertook to break through the secrecy barrier.
She writes that her own experience “prompted me to think what many people suspect: the charged prices can be highly inflated, and actual payments are more negotiable than I had thought. The cost problem affects not just uninsured people, but also insured people dealing with high deductibles, co-insurance, out-of-network spending, and unwelcome sky-high bills.”
Her website presents the range of cash prices identified for about 30 “shoppable” procedures in areas where the team focuses its work, and also the Medicare rate for all 8,400 codes in the Healthcare Common Procedure Coding System (HCPCS) database. “The Medicare rate is the closest thing available in the marketplace to a fixed or benchmark price,” Pinder explains.
The searchable website also allows people to share prices and experiences. “We find there are about 15-20 searches of the database for every contact to share information via the on-line form,” she writes. Many people report substantial cost savings.
“We have no political agenda: We simply think people should know what things cost,” Pinder writes. “We have generated a conversation about medical cost, giving people a voice in the debate and active roles in controlling health spending. Administrators can hear what patients think, independent doctors can contribute their expertise, and lawmakers and regulators can learn what’s really going on among patients.”
She found that “patients can often save money by putting away their insurance card and paying cash.” Others searching for prices might find that in-network prices vary widely; for example, In New Orleans, “we saved one woman $3,786” by showing her that one in-network provider was that much less expensive than another. Over 7 years of surveying prices, she and her colleagues found that “cash prices seem to stay relatively flat…. Now people are beginning to ask: Why pay a hefty insurance premium if it gets you a higher price?”
Pinder concludes that: “This constant effort by insurers and health systems to keep prices secret must end, and our goal is to make that happen as soon as possible.”
The Journal of American Physicians and Surgeons is published by the Association of American Physicians and Surgeons (AAPS), a national organization representing physicians in all specialties since 1943.
Read full article: http://www.jpands.org/vol23no2/pinder.pdf