Make informed choices about your health care
Glenwood Springs, Colorado CO
When was the last time you bought a car without even looking at the price tag? Or, signed a mortgage having never looked at the house or the cost? Likely never.
But for most Americans, that’s exactly what we do each and every time we walk into a doctor’s office for a routine check-up, or go to the hospital for a minor procedure or major surgery, or have blood work drawn and analyzed.
Americans spent $2.6 trillion on health care in 2010, yet we haven’t the faintest idea what any treatment costs at the point of service, or how it compares with the same treatment elsewhere. However, prices vary wildly and seemingly without reason, even here in our own backyard.
For 15 years now, I am twice yearly required to submit to a number of blood tests to monitor my hypothyroidism. In June 2011, my primary care physician ordered a series of routine blood tests, and I requested a full thyroid panel be done, which is customary for me once a year. Considered preventative medicine, these five thyroid tests cost about $400 and are covered by my insurance.
A month later, I received a bill for labs conducted by Valley View Hospital in Glenwood Springs for a whopping $1,434, with absolutely no breakdown of costs. Nearly a year later, after numerous phone calls to my physician, Valley View and my insurance company, I am only now getting to the bottom of the charges.
During that time, I received a letter from Valley View stating, “VVH is trying to be competitive in their pricing. VVH staffs the lab 24 hours and is able to process 95 percent of procedures on-site and this is why some of the charges for lab procedures are higher.”
Never before had these five thyroid tests cost so much. Curious about Valley View’s reasoning for its higher prices, I made phone calls to three of its competitors. Here are the total costs quoted for the same five thyroid tests:
Vail Valley Hospital: $351
St. Mary’s Hospital and Regional Medical Center, Grand Junction: $420
Aspen Valley Hospital: $548
Valley View Hospital: $921
Note: Price quotes are current as of January 2012. Each competing lab confirmed 24/7 staffing and conducting the majority of tests in-house. All prices are based on out-of-pocket-cost before any insurance is applied.
The experience, while costly, taught me a lot about our fragmented health care system, how little patients or providers know about the real cost of health care, and how hard it is for patients to make price-based decisions when the system isn’t designed with that in mind. Furthermore, most people don’t have the time, connections, or industry knowledge to pursue this.
In the past, there’s been little incentive for physicians and hospitals to provide cost information because insurance was picking up the tab. But with growing out-of-pocket expenses, the time is ripe for a transparent, consumer-driven health care system.
In my research, I discovered several new, easy-to-use websites that can help people make informed health care decisions, as well as contribute to the bettering of the system. Because if no one challenges the status quo, we can expect more of the same.
• OutofPocket.com was created to educate consumers about true health care prices. This website allows you to search for prices for health care services, and allows you to post prices you paid for health care services.
• Healthcarebluebook.com was developed by a physician whose son has cerebral palsy and who also grew weary of lack of cost transparency for health care. It is a free consumer guide to help determine fair prices in your area for health care services and allows you to post your costs for health care services. It also provides employers with analytics to understand provider network costs and comprehensive programs to support employers with high deductible health plans, consumer directed health plans and reference pricing.
• Simplee.com is a new web-based service that can help you get control of health care costs and expenses. Similar to Mint.com for personal finance accounts, Simplee safely and securely links to your health insurance and transforms it into a clean, easy-to-read dashboard for tracking and controlling spending, reducing paperwork, expanding health care options and saving money.
• Webmd.com Health Insurance Negotiator is an online column written by Lisa Zamosky, a journalist whose work has appeared in the Los Angeles Times, MSNBC.com, Kaiser Health News, the Chicago Tribune, Baltimore Sun, Prevention, and iVillage.com, among others. She writes about health insurance, the business of health care, a wide range of consumer health topics, fitness, nutrition, and biopharmaceuticals.
Patti Hecht-Sills is an advocate for transparency in the health care and insurance industries in the U.S. She is retired from marketing in the Vail and Roaring Fork Valleys and lives in Eagle-Vail.
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