Dr. Neel Shah, founder of the non-profit organization Cost of Care recently announced an essay contest with a $1000 prizes.
I encourage patients and clinicians to enter the essay contest. By sharing your stories, you will help other patients navigate the system.
The national essay contest offers $1000 prizes for the best anecdotes from patients and clinicians illustrating the importance of cost-awareness in medical decision-making.
Judges for the contest include:
Gov. Michael Dukakis, former Democratic nominee for President of the United States
Tim Johnson, Chief Medical Correspondent of ABC News
Atul Gawande, surgeon and New Yorker staff writer
Jeffrey Flier, Dean of Harvard Medical School
Gov. Michael Leavitt, former United States Secretary of Health and Human services
Entries must be no longer than 750 words, and should be typed and double-spaced. Students strongly encouraged to submit an anecdote. E-mail submissions to contest@costsofcare.org are preferred, however entries may also be mailed to
Costs of Care
21 Father Gilday Street, Suite 115
Boston, MA 02118
Deadline: November 1st, 2010
Additional submission information available here.
Thursday, September 9, 2010
Angies List Partnership
Healthcare Blue Book is pleased to announce our partnership with Angie's List.
Angie's List has a lot of great health information in their health section.
Our full press release is below:
Angie’s List and Healthcare Blue Book Partner
to Help Consumers Save Money on Doctor Bills
After months of cracking open the secret that consumers can negotiate their medical bills, Angie’s List and Healthcare Blue Book today launched a service designed to help patients shop around for the best price before they even agree to treatment and incur those bills.
“So many of us overpay for health care for two reasons: medical billing is too complicated to figure out and we’re so used to not having any control over price, that we don’t even ask about it,” said Angie Hicks, founder of Angie’s List, the nation’s premier provider of consumer reviews on local doctors, dentists and service companies. “But you can save hundreds, if not thousands, of dollars with just a little bit of effort and still get high quality care.”
A majority of the Angie’s List members (85 percent) responding to a nationwide online poll in July said health care providers should publish their prices, and 61 percent would happily shop around if only they knew the prices area providers charged. Only 25 percent of respondents said they ask about pricing before agreeing to treatment.
“The Healthcare Blue Book takes the mystery out of health care pricing,” said Dr. Jeffrey Rice, founder of the Healthcare Blue Book. “To get fair prices, patients must look up the accepted, average local prices and then make sure their provider agrees to that price before they get care.”
Consumers can sometimes successfully negotiate prices down once they’ve been billed. But Rice cautions, “It is often too late to get a fair price if you try to negotiate after you already received the care at an overpriced provider.”
Starting today on Angieslist.com, members can access Healthcare Blue Book’s local pricing information on visits ranging from ordinary pediatrician visits to complicated surgeries. Blue Book will also walk consumers through the negotiation process, and explain exactly what is required to get a fair price.
While the new tool is simple, Hicks and Rice said consumers may have a difficult time adjusting to this new way of looking at health care. Many consumers are savvy about price shopping for big ticket items like houses and cars, and smaller items like household products, but medical pricing has not traditionally been considered something to haggle over.
That will change, Hicks and Rice predict, once consumers realize, how big the price discrepancies can be. For example:
• In Washington, D.C., prices for an MRI of a right knee without contrast at five imaging centers ranged from $400 to $1504. The Healthcare Blue Book fair price: $912.
• An MRI of the abdomen at three Atlanta imaging labs with and without contrast ranged from $1,190 to $2,543, if payment was cash. The Healthcare Blue Book fair price: $836.
• Cost for an MRI of the lumbar spine with contrast ranged from $500 to $2,661 among eight Chicago hospitals and imaging centers. The Healthcare Blue Book fair price: $522.
In a May 2010 nationwide member poll, Angie’s List found that 57 percent of respondents have never negotiated a medical bill. Nearly 25 percent of them didn’t even know they had that option.
Hicks and Rice cautioned consumers from putting too much emphasis on price when it comes to medical care. Finding health care providers who meet your specific needs and have all the necessary licensing and training is paramount. With the Angie’s List and Healthcare Blue Book partnership, all that information is easily available in one location.
Patients with insurance should make sure they find in-network providers that charge fair rates. Patients without insurance are likely to be charged the highest fees. They particularly need to ask about prices and get agreement up front, Rice and Hicks said.
Angie’s List and Healthcare Blue Book’s Tips on Negotiating Your Medical Bill:
1. Know what you’re up against: Before you agree to a course of treatment, research what you need done, get information on the provider you’ve chosen and the local rate for that service on Healthcare Blue Book, so you know if the rates your doctor suggests are in line with them.
2. Ask for a discount. Cash (or immediate payment) is king in a medical facility, just as is it is with retailers and service companies. Ask if there’s a discount for upfront payment or a no-interest payment plan. Be sure to follow all applicable health insurance rules.
3. Get quotes in writing: If you are price shopping before you have a procedure done, get a signature, name and title to go along with the price quoted.
4. Cover every doctor in the room and the cost of the facility where treatment is given: When getting prices, be sure you cover all fees associated with your procedure, rather than just the surgical costs. (i.e. anesthesiologist, radiologist, facility fee, laboratory costs, etc.)
5. Be polite: Don’t be overly aggressive in seeking a discount. If you cannot afford what you need done, tell your provider. Some medical practices will alert you to payment options, but some may not be actively promoting them. Start with the office clerk you’d normally check out with, but don’t be afraid to ask for a billing manager if you don’t feel like you’re getting a full answer.
6. Review all the paperwork: If a bill seems out of line, ask about it. Check around to determine if the bill is in line with what other facilities charge. Call the billing department armed with your information and ask for the lower charge.
7. Call in expert help: Medical billing is so complex that it’s spawned a new industry of professional bill reviewers, sometimes called medical billing advocates. These specialists are trained to look for incorrect billing codes and duplicate charges. Check credentials before you hire, though. Experts say advocates average recovery of 17 to 49 percent and charge an average contingency fee of about 30 percent. Some charge flat fees, as well.
-----
1,237 Angie’s List members responded to the May online poll. 1,015 Angie’s List members responded to the July online poll.
-----
Angie’s List collects consumer reviews on local contractors and doctors in more than 500 service categories. Currently, more than 1 million consumers across the U.S. rely on Angie’s List to help them make the best hiring decisions. Members get unlimited access to local ratings via Internet or phone, exclusive discounts, the Angie’s List magazine and help from the Angie’s List complaint resolution service. Take a quick tour of Angie’s List and view the latest Angie’s List news.
Healthcarebluebook.com, headquartered in Nashville, TN, is a healthcare pricing tool that helps consumers and companies determine what fair prices are for healthcare services and treatments in their markets. The www.healthcarebluebook.com web site can be customized to employers’ needs by offering information that allows employees to identify lower cost and high quality providers within their existing employer-sponsored health plan.
Angie's List has a lot of great health information in their health section.
Our full press release is below:
Angie’s List and Healthcare Blue Book Partner
to Help Consumers Save Money on Doctor Bills
After months of cracking open the secret that consumers can negotiate their medical bills, Angie’s List and Healthcare Blue Book today launched a service designed to help patients shop around for the best price before they even agree to treatment and incur those bills.
“So many of us overpay for health care for two reasons: medical billing is too complicated to figure out and we’re so used to not having any control over price, that we don’t even ask about it,” said Angie Hicks, founder of Angie’s List, the nation’s premier provider of consumer reviews on local doctors, dentists and service companies. “But you can save hundreds, if not thousands, of dollars with just a little bit of effort and still get high quality care.”
A majority of the Angie’s List members (85 percent) responding to a nationwide online poll in July said health care providers should publish their prices, and 61 percent would happily shop around if only they knew the prices area providers charged. Only 25 percent of respondents said they ask about pricing before agreeing to treatment.
“The Healthcare Blue Book takes the mystery out of health care pricing,” said Dr. Jeffrey Rice, founder of the Healthcare Blue Book. “To get fair prices, patients must look up the accepted, average local prices and then make sure their provider agrees to that price before they get care.”
Consumers can sometimes successfully negotiate prices down once they’ve been billed. But Rice cautions, “It is often too late to get a fair price if you try to negotiate after you already received the care at an overpriced provider.”
Starting today on Angieslist.com, members can access Healthcare Blue Book’s local pricing information on visits ranging from ordinary pediatrician visits to complicated surgeries. Blue Book will also walk consumers through the negotiation process, and explain exactly what is required to get a fair price.
While the new tool is simple, Hicks and Rice said consumers may have a difficult time adjusting to this new way of looking at health care. Many consumers are savvy about price shopping for big ticket items like houses and cars, and smaller items like household products, but medical pricing has not traditionally been considered something to haggle over.
That will change, Hicks and Rice predict, once consumers realize, how big the price discrepancies can be. For example:
• In Washington, D.C., prices for an MRI of a right knee without contrast at five imaging centers ranged from $400 to $1504. The Healthcare Blue Book fair price: $912.
• An MRI of the abdomen at three Atlanta imaging labs with and without contrast ranged from $1,190 to $2,543, if payment was cash. The Healthcare Blue Book fair price: $836.
• Cost for an MRI of the lumbar spine with contrast ranged from $500 to $2,661 among eight Chicago hospitals and imaging centers. The Healthcare Blue Book fair price: $522.
In a May 2010 nationwide member poll, Angie’s List found that 57 percent of respondents have never negotiated a medical bill. Nearly 25 percent of them didn’t even know they had that option.
Hicks and Rice cautioned consumers from putting too much emphasis on price when it comes to medical care. Finding health care providers who meet your specific needs and have all the necessary licensing and training is paramount. With the Angie’s List and Healthcare Blue Book partnership, all that information is easily available in one location.
Patients with insurance should make sure they find in-network providers that charge fair rates. Patients without insurance are likely to be charged the highest fees. They particularly need to ask about prices and get agreement up front, Rice and Hicks said.
Angie’s List and Healthcare Blue Book’s Tips on Negotiating Your Medical Bill:
1. Know what you’re up against: Before you agree to a course of treatment, research what you need done, get information on the provider you’ve chosen and the local rate for that service on Healthcare Blue Book, so you know if the rates your doctor suggests are in line with them.
2. Ask for a discount. Cash (or immediate payment) is king in a medical facility, just as is it is with retailers and service companies. Ask if there’s a discount for upfront payment or a no-interest payment plan. Be sure to follow all applicable health insurance rules.
3. Get quotes in writing: If you are price shopping before you have a procedure done, get a signature, name and title to go along with the price quoted.
4. Cover every doctor in the room and the cost of the facility where treatment is given: When getting prices, be sure you cover all fees associated with your procedure, rather than just the surgical costs. (i.e. anesthesiologist, radiologist, facility fee, laboratory costs, etc.)
5. Be polite: Don’t be overly aggressive in seeking a discount. If you cannot afford what you need done, tell your provider. Some medical practices will alert you to payment options, but some may not be actively promoting them. Start with the office clerk you’d normally check out with, but don’t be afraid to ask for a billing manager if you don’t feel like you’re getting a full answer.
6. Review all the paperwork: If a bill seems out of line, ask about it. Check around to determine if the bill is in line with what other facilities charge. Call the billing department armed with your information and ask for the lower charge.
7. Call in expert help: Medical billing is so complex that it’s spawned a new industry of professional bill reviewers, sometimes called medical billing advocates. These specialists are trained to look for incorrect billing codes and duplicate charges. Check credentials before you hire, though. Experts say advocates average recovery of 17 to 49 percent and charge an average contingency fee of about 30 percent. Some charge flat fees, as well.
-----
1,237 Angie’s List members responded to the May online poll. 1,015 Angie’s List members responded to the July online poll.
-----
Angie’s List collects consumer reviews on local contractors and doctors in more than 500 service categories. Currently, more than 1 million consumers across the U.S. rely on Angie’s List to help them make the best hiring decisions. Members get unlimited access to local ratings via Internet or phone, exclusive discounts, the Angie’s List magazine and help from the Angie’s List complaint resolution service. Take a quick tour of Angie’s List and view the latest Angie’s List news.
Healthcarebluebook.com, headquartered in Nashville, TN, is a healthcare pricing tool that helps consumers and companies determine what fair prices are for healthcare services and treatments in their markets. The www.healthcarebluebook.com web site can be customized to employers’ needs by offering information that allows employees to identify lower cost and high quality providers within their existing employer-sponsored health plan.
Sunday, August 1, 2010
Doctors and Transparency
Anna Mathews wrote a nice article in the WSJ recently.
The article states that several organizations including the American Medical Association are criticizing the growing efforts by health plans to steer patients toward certain physicians based on cost or quality. The groups sent their arguments in a letter to insurers stating that the rankings may be unreliable and unfair. "There are serious flaws in health insurers' programs to try to rate individual physicians," said Cecil Wilson, president of the AMA.
Well, no doubt rating systems aren't perfect. They probably never will be.
But where are the AMA rating tools and transparency tools? Are there any physician organization leading the effort to improve quality ratings and make costs fair and transparent?
Patients want information on cost and quality. They will use the best information they can find.
If the AMA doesn't like the available rating tools, then they should take a leadership role in developing better ones.
The Healthcare Blue Book has helped thousands of patients find fair prices for care. It will be great to add the AMA's quality and cost information when they decide to share it.
The article states that several organizations including the American Medical Association are criticizing the growing efforts by health plans to steer patients toward certain physicians based on cost or quality. The groups sent their arguments in a letter to insurers stating that the rankings may be unreliable and unfair. "There are serious flaws in health insurers' programs to try to rate individual physicians," said Cecil Wilson, president of the AMA.
Well, no doubt rating systems aren't perfect. They probably never will be.
But where are the AMA rating tools and transparency tools? Are there any physician organization leading the effort to improve quality ratings and make costs fair and transparent?
Patients want information on cost and quality. They will use the best information they can find.
If the AMA doesn't like the available rating tools, then they should take a leadership role in developing better ones.
The Healthcare Blue Book has helped thousands of patients find fair prices for care. It will be great to add the AMA's quality and cost information when they decide to share it.
Another TV spot
Healthcare Blue Book was recently recommened on the Today Show.
Check out the video here.
Here is a link to an LA times article we participated in as well.
We appreciate those who are helping to spread the word to patients.
If patients will review prices before they seek care, they are likely to improve the quality of their care and save $1000's too.
Check out the video here.
Here is a link to an LA times article we participated in as well.
We appreciate those who are helping to spread the word to patients.
If patients will review prices before they seek care, they are likely to improve the quality of their care and save $1000's too.
Sunday, July 25, 2010
Healthcare Blue Book in the News
Healthcare Blue Book was included in 2 recent TV shows.
We did an interview for a story by Susan Koeppen on The Early Show on CBS News. You can see the full story and interview with Dr. Jeffrey Rice on the link above.
NBC 12 in Virginia also did a feature news cast on Healthcare Blue Book. You can see the interview with Aimee Stern and story here.
We did an interview for a story by Susan Koeppen on The Early Show on CBS News. You can see the full story and interview with Dr. Jeffrey Rice on the link above.
NBC 12 in Virginia also did a feature news cast on Healthcare Blue Book. You can see the interview with Aimee Stern and story here.
Sunday, July 18, 2010
Soceity of Acutuaries Support Pricing Transparency
The Society of Actuaries released a study supporting the need for pricing and quality transparency in health care.
In a recent release, Actuaries Believe More Transparency in the U.S. Healthcare System Would Help Bend the Cost Curve Downward, they report that creating more transparency between doctors and patients, and the provider community and patients, will be an effective approach at bending the cost curve downward. For example, 86 percent of the surveyed healthcare actuaries recommend making prices for treatments more visible and available for patients. Seventy-nine percent recommend educating consumers and providers on the efficacy of care.
In a separate survey they conducted of consumers, they found that two-thirds of those surveyed support the actuaries' recommendations on the benefits of transparency. Specifically, thirty-seven percent of consumers feel they could better control their own healthcare costs if healthcare providers – or their insurance company – told them about the costs of medical services and the quality of the outcome of procedures. And thirty percent feel they could better control their healthcare costs if, before administering a medical procedure, their physician informed them about the costs of the procedure, the number of times he/she has performed the procedure, and its results.
Healthcare Blue Book is working with provider groups, employers and insurance companies to promote pricing and quality transparency. Employers see transparency as one of the best ways to improve quality and lower costs.
In a recent release, Actuaries Believe More Transparency in the U.S. Healthcare System Would Help Bend the Cost Curve Downward, they report that creating more transparency between doctors and patients, and the provider community and patients, will be an effective approach at bending the cost curve downward. For example, 86 percent of the surveyed healthcare actuaries recommend making prices for treatments more visible and available for patients. Seventy-nine percent recommend educating consumers and providers on the efficacy of care.
In a separate survey they conducted of consumers, they found that two-thirds of those surveyed support the actuaries' recommendations on the benefits of transparency. Specifically, thirty-seven percent of consumers feel they could better control their own healthcare costs if healthcare providers – or their insurance company – told them about the costs of medical services and the quality of the outcome of procedures. And thirty percent feel they could better control their healthcare costs if, before administering a medical procedure, their physician informed them about the costs of the procedure, the number of times he/she has performed the procedure, and its results.
Healthcare Blue Book is working with provider groups, employers and insurance companies to promote pricing and quality transparency. Employers see transparency as one of the best ways to improve quality and lower costs.
Thursday, May 13, 2010
Federal Legislation for Pricing Transparency?
The House has 3 bills under consideration for promoting health care pricing transparency. Unfortunately, there is no commitment for moving the legislation through this year. And no bills introduced in the Senate yet.
The worst indication of where this may be heading came from Frank Pallone, chairman of the Energy and Commerce health subcommittee. “The concern I guess is about the unintended consequences of too much transparency,” he said. Apparently he believes such transparency will make prices go higher since Peter Orszag stated so back in 2008. If we assume that future health benefits will preserve the worst parts of the insurance models, then maybe that is possible.
However, if we look at private reform and adopt the newer benefit designs with consumerism, then we are much more likely to see prices fall as consumers engage in their care decisions.
Until the legislature brings meaningful pricing disclosure requirements, consumers can find fair price estimates for free at Healthcare Blue Book.
The three bill were summarized by California HealthLine
Bill Details
HR 4700: The bill -- sponsored by Rep. Steve Kagan (D-Wis.) without any Republican support -- would require hospitals, physicians, nurses, pharmacies, and a number of manufacturers and vendors to disclose publicly the prices they would charge patients. The HHS secretary would levy a fine on providers and vendors that fail to comply with the requirement (Ethridge, CQ Today, 5/6).
HR 2249: Cosponsored by Texas Reps. Gene Green (D) and Michael Burgess (R), the bill calls for transparency in hospital charges (Pecquet, "Blog Briefing Room," The Hill, 5/6). The legislation also would expand reporting requirements to all 50 states and require insurance companies to disclose out-of-pocket cost estimates for a number of medical procedures (Reichard, CQ HealthBeat, 5/6).
HR 4803: The proposal, sponsored by House Energy and Commerce Committee ranking member Rep. Joe Barton (R-Texas) with broad Democratic support, would cover ambulatory surgical centers serving patients who are not hospitalized after their operation ("Blog Briefing Room," The Hill, 5/6). It would require the centers, as well as hospitals and private and public health insurers, to disclose to their patients and customers information about the costs for services they provide and the items and services that they cover, respectively (CQ Today, 5/6).
See also comments at:
The Hill
The worst indication of where this may be heading came from Frank Pallone, chairman of the Energy and Commerce health subcommittee. “The concern I guess is about the unintended consequences of too much transparency,” he said. Apparently he believes such transparency will make prices go higher since Peter Orszag stated so back in 2008. If we assume that future health benefits will preserve the worst parts of the insurance models, then maybe that is possible.
However, if we look at private reform and adopt the newer benefit designs with consumerism, then we are much more likely to see prices fall as consumers engage in their care decisions.
Until the legislature brings meaningful pricing disclosure requirements, consumers can find fair price estimates for free at Healthcare Blue Book.
The three bill were summarized by California HealthLine
Bill Details
HR 4700: The bill -- sponsored by Rep. Steve Kagan (D-Wis.) without any Republican support -- would require hospitals, physicians, nurses, pharmacies, and a number of manufacturers and vendors to disclose publicly the prices they would charge patients. The HHS secretary would levy a fine on providers and vendors that fail to comply with the requirement (Ethridge, CQ Today, 5/6).
HR 2249: Cosponsored by Texas Reps. Gene Green (D) and Michael Burgess (R), the bill calls for transparency in hospital charges (Pecquet, "Blog Briefing Room," The Hill, 5/6). The legislation also would expand reporting requirements to all 50 states and require insurance companies to disclose out-of-pocket cost estimates for a number of medical procedures (Reichard, CQ HealthBeat, 5/6).
HR 4803: The proposal, sponsored by House Energy and Commerce Committee ranking member Rep. Joe Barton (R-Texas) with broad Democratic support, would cover ambulatory surgical centers serving patients who are not hospitalized after their operation ("Blog Briefing Room," The Hill, 5/6). It would require the centers, as well as hospitals and private and public health insurers, to disclose to their patients and customers information about the costs for services they provide and the items and services that they cover, respectively (CQ Today, 5/6).
See also comments at:
The Hill
Sunday, May 2, 2010
Wisconsin Legislation for Price Transparency
In the fall of 2009 there were a lot of articles on 'facility fees' that are added to doctor's bills for office visits when the doctor works for a hospital.
Wisconsin is now considering requiring pricing transparency for the extra fees. Proposed legislation (AB 207) would require clinics that charge "facility fees" - meant to cover extra costs incurred by hospital-owned facilities - to tell people about them at the time they make appointments and to provide an estimate of what they will be.
Wisconsin has already passed one law to encourage pricing transparency, thought the law does not take effect until 2011. Wisconsin Act 146 requires hospitals and other health care providers to give patients a list of common procedures and what the provider charges for them, as well as what Medicare and insurers typically pay for them. This will provide some very useful information for patients.
In addition, Wisconsin is considering a law that would would require health care providers to give patients an estimate of the cost of any procedure, test or other service if it is expected to be more than $500. It would also require more disclosure to patients by insurance companies of the coverage amounts for certain medical services and estimates of out-of-pocket costs and costs for services from out-of-network providers. (Assembly Bill 539)
Wisconsin is now considering requiring pricing transparency for the extra fees. Proposed legislation (AB 207) would require clinics that charge "facility fees" - meant to cover extra costs incurred by hospital-owned facilities - to tell people about them at the time they make appointments and to provide an estimate of what they will be.
Wisconsin has already passed one law to encourage pricing transparency, thought the law does not take effect until 2011. Wisconsin Act 146 requires hospitals and other health care providers to give patients a list of common procedures and what the provider charges for them, as well as what Medicare and insurers typically pay for them. This will provide some very useful information for patients.
In addition, Wisconsin is considering a law that would would require health care providers to give patients an estimate of the cost of any procedure, test or other service if it is expected to be more than $500. It would also require more disclosure to patients by insurance companies of the coverage amounts for certain medical services and estimates of out-of-pocket costs and costs for services from out-of-network providers. (Assembly Bill 539)
Friday, April 30, 2010
Alfie Tackles Health Literacy
Jeff Knott is a strong champion of health literacy. Based on his personal experiences with the health care system, he is committed to helping others understand the system and advocate for themselves to receive quality care.
He combines comedy with education to provide a fun learning experience for patients.
Watch for Alfie. You can see the educational videos on youtube.
Here are a few of them.
Dirty Magazines
Nurse Practitioners
Staph Infections
He combines comedy with education to provide a fun learning experience for patients.
Watch for Alfie. You can see the educational videos on youtube.
Here are a few of them.
Dirty Magazines
Nurse Practitioners
Staph Infections
Friday, April 2, 2010
AHIP Calls for Transparency
The consequence of health reform continue to unfold.
One interesting development is the response by health plans to the HHS request for transparency of price increases.
AHIP wrote a letter to HHS suggesting that health plans would be glad to provide transparency into rate increases, and would like the same standard to be applied to providers.
The letter reads in part:
"As you request transparency from our members, we urge you also to consider pursuing transparency for hospitals, physicians, pharmaceutical and device companies, and other suppliers. Consumers should have data on year-to-year price increases in these sectors, as well as quality performance information. We believe this is an opportunity to ask of all other sectors what you are asking of health plans. Pursuing transparency in these sectors is essential both to educate consumers about what drives health care costs and to ensure that patients and their doctors have the information and decision support tools they need to make informed decisions in accessing care and in choosing among providers and care options."
Asking health care providers to explain price increases implies that consumers know what prices are to begin with.
What an excellent idea.
The Healthcare Blue Book welcomes the idea that HHS will encourage all providers to provide real pricing transparency to consumers.
One interesting development is the response by health plans to the HHS request for transparency of price increases.
AHIP wrote a letter to HHS suggesting that health plans would be glad to provide transparency into rate increases, and would like the same standard to be applied to providers.
The letter reads in part:
"As you request transparency from our members, we urge you also to consider pursuing transparency for hospitals, physicians, pharmaceutical and device companies, and other suppliers. Consumers should have data on year-to-year price increases in these sectors, as well as quality performance information. We believe this is an opportunity to ask of all other sectors what you are asking of health plans. Pursuing transparency in these sectors is essential both to educate consumers about what drives health care costs and to ensure that patients and their doctors have the information and decision support tools they need to make informed decisions in accessing care and in choosing among providers and care options."
Asking health care providers to explain price increases implies that consumers know what prices are to begin with.
What an excellent idea.
The Healthcare Blue Book welcomes the idea that HHS will encourage all providers to provide real pricing transparency to consumers.
Monday, March 29, 2010
Walgreens Pulls Out of Mediciad Program
Walgreens announced that it was pulling out of Washington state's Medicaid program because the state was paying prices that did not cover the actual cost of many of the program's medications.
For many years the government programs (Medicare and Medicaid) have paid lower prices than other payers. They are able to do this because of the hidden subsidies that other payers pay to make up for short falls in government program payments.
With health reform upon us, we will need to closely watch these trends. Part of the reform package brings Medicaid payments up to Medicare levels. But will this create even more pressure to further lower Medicare rates?
On top of the hidden subsidies, the private payers will now pay a premium tax too.
Does this ultimately push the private insurers out of business and leave us with a single payer option? Or does the government v. private pay differential grow enough that we end up at a two tiered system?
Time will tell, but as providers refuse to deal with certain payers, politicians and the markets will react.
We welcome the provider feedback (Walgreens as an example) that incentives can change provider behavior. If politicians and the markets would incorporate more consumer incentives, then maybe we will end up with a value based system that patients will embrace.
For many years the government programs (Medicare and Medicaid) have paid lower prices than other payers. They are able to do this because of the hidden subsidies that other payers pay to make up for short falls in government program payments.
With health reform upon us, we will need to closely watch these trends. Part of the reform package brings Medicaid payments up to Medicare levels. But will this create even more pressure to further lower Medicare rates?
On top of the hidden subsidies, the private payers will now pay a premium tax too.
Does this ultimately push the private insurers out of business and leave us with a single payer option? Or does the government v. private pay differential grow enough that we end up at a two tiered system?
Time will tell, but as providers refuse to deal with certain payers, politicians and the markets will react.
We welcome the provider feedback (Walgreens as an example) that incentives can change provider behavior. If politicians and the markets would incorporate more consumer incentives, then maybe we will end up with a value based system that patients will embrace.
Sunday, March 21, 2010
Health Reform and Consumerism
Regardless of your position on the current health reform, it will soon impact consumerism movements that have been shaping the healthcare landscape and helping to hold prices down.
Consumerism provides individual patients with some economic responsibility as they make decisions regarding their healthcare; hoping to strike a balance between making care affordable but also making sure those paying for care are getting value for the resource they spend.
The reform legislation will probably change over time, but as of today, based on the Senate's bill; here are some of the impacts on consumerism:
Promoting consumerism:
Linking payments to hospitals to providers based upon quality of care instead of volume of services (2012).
Linking payments to physicians to providers based upon quality of care instead of volume of services (2013).
Taxing high cost insurance plans (2013).
Increasing the threshold for claiming itemized deductions for medical expenses (2013).
Limiting Consumerism:
Eliminating Lifetime Limits and Restricting Use of Annual Limits (2010).
Covering Preventive Health Services at 100% (2010).
Reducing the Part D “Donut Hole” or Coverage Gap (2010).
Limiting Health Flexible Savings Account Contributions (2011).
Eliminating Annual Limits on health insurance coverage (2014).
It will be interesting to see how the final legislation changes over time and what its ultimate impact will be on consumerism.
Based upon patient usage of the Healthcare Blue Book, we know that many patients are very capable of finding high quality care at reasonable prices when they have an incentive to do so.
Consumerism provides individual patients with some economic responsibility as they make decisions regarding their healthcare; hoping to strike a balance between making care affordable but also making sure those paying for care are getting value for the resource they spend.
The reform legislation will probably change over time, but as of today, based on the Senate's bill; here are some of the impacts on consumerism:
Promoting consumerism:
Linking payments to hospitals to providers based upon quality of care instead of volume of services (2012).
Linking payments to physicians to providers based upon quality of care instead of volume of services (2013).
Taxing high cost insurance plans (2013).
Increasing the threshold for claiming itemized deductions for medical expenses (2013).
Limiting Consumerism:
Eliminating Lifetime Limits and Restricting Use of Annual Limits (2010).
Covering Preventive Health Services at 100% (2010).
Reducing the Part D “Donut Hole” or Coverage Gap (2010).
Limiting Health Flexible Savings Account Contributions (2011).
Eliminating Annual Limits on health insurance coverage (2014).
It will be interesting to see how the final legislation changes over time and what its ultimate impact will be on consumerism.
Based upon patient usage of the Healthcare Blue Book, we know that many patients are very capable of finding high quality care at reasonable prices when they have an incentive to do so.
Thursday, March 11, 2010
Save Big
Elisabeth Leamy who is the Consumer Correspondent for the Good Morning America show has a new book out called Save Big.
In addition to tips on expenses around housing, transportation, loans and grocery shopping, she has an entire section devoted to healthcare costs.
It is definitely worth reading and can help consumers with health insurance suggestions as well as suggestions for finding care and prescriptions.
Not surprisingly she recommends negotiating with your doctor.
We were glad to see that she suggested using The Healthcare Blue Book as a great place to find out how much your care should cost. As Leamy reports, the Healthcare Blue Book's fair price is "a great starting point for discussion- and negotiation."
In addition to tips on expenses around housing, transportation, loans and grocery shopping, she has an entire section devoted to healthcare costs.
It is definitely worth reading and can help consumers with health insurance suggestions as well as suggestions for finding care and prescriptions.
Not surprisingly she recommends negotiating with your doctor.
We were glad to see that she suggested using The Healthcare Blue Book as a great place to find out how much your care should cost. As Leamy reports, the Healthcare Blue Book's fair price is "a great starting point for discussion- and negotiation."
Sunday, February 28, 2010
Why do we pay more money without getting better quality care?
Value is one of the most important missing topics in the health reform debate.
We might not be so concerned with how much health care costs or how much of our national budget gets devoted to health care, IF we felt we were getting good value for our money. But the fact is that we all know we aren't getting a good value. We see prices continue to rise faster than inflation and very often that is accompanied with lower levels of service, less time with our doctors, etc.
There have been some studies focused squarely on this issue. I have commented before on the Health Affairs article last year.
Now comes a nice report from Massachusetts that examined the costs of healthcare and how they relate to quality.
What did they find?
Their preliminary review revealed serious system-wide failings in the commercial health care marketplace which, if unaddressed, imperil access to affordable, quality health care.
Their investigation has shown:
- Prices paid by health insurance companies to hospitals and physician groups vary significantly within the same geographic area and amongst providers offering similar levels of service.
- Price variations are not correlated to (1) quality of care, (2) the sickness or
complexity of the population being served, (3) the extent to which a provider is
responsible for caring for a large portion of patients on Medicare or Medicaid, or (4) whether a provider is an academic teaching or research facility. Moreover, (5) price variations are not adequately explained by differences in hospital costs of delivering similar services at similar facilities.
At The Healthcare Blue Book our work with employers reveals this fact frequently. We routinely see employees paying 500% more than necessary for common services while getting no better (and sometimes lower) quality of care. These are prices paid to in-network providers; and prices that ultimately are paid for by the employer under their health benefit costs.
The more research the better, but each study points in the same direction: there is a lot of opportunity for employers and employees to lower costs and raise quality.
We might not be so concerned with how much health care costs or how much of our national budget gets devoted to health care, IF we felt we were getting good value for our money. But the fact is that we all know we aren't getting a good value. We see prices continue to rise faster than inflation and very often that is accompanied with lower levels of service, less time with our doctors, etc.
There have been some studies focused squarely on this issue. I have commented before on the Health Affairs article last year.
Now comes a nice report from Massachusetts that examined the costs of healthcare and how they relate to quality.
What did they find?
Their preliminary review revealed serious system-wide failings in the commercial health care marketplace which, if unaddressed, imperil access to affordable, quality health care.
Their investigation has shown:
- Prices paid by health insurance companies to hospitals and physician groups vary significantly within the same geographic area and amongst providers offering similar levels of service.
- Price variations are not correlated to (1) quality of care, (2) the sickness or
complexity of the population being served, (3) the extent to which a provider is
responsible for caring for a large portion of patients on Medicare or Medicaid, or (4) whether a provider is an academic teaching or research facility. Moreover, (5) price variations are not adequately explained by differences in hospital costs of delivering similar services at similar facilities.
At The Healthcare Blue Book our work with employers reveals this fact frequently. We routinely see employees paying 500% more than necessary for common services while getting no better (and sometimes lower) quality of care. These are prices paid to in-network providers; and prices that ultimately are paid for by the employer under their health benefit costs.
The more research the better, but each study points in the same direction: there is a lot of opportunity for employers and employees to lower costs and raise quality.
Saturday, February 20, 2010
If Air Travel Worked Like Health Care
People are always comparing the health care system to other industries.... Well now you can watch the movie.
Check out this video, you may not know whether to laugh or cry.
Of course they highlight the issues of transparency and the challenges faced by consumers in having to work with multiple providers to get a single service.
The Healthcare Blue Book is working to solve both of these problems. Maybe if all the CEOs working in the healthcare system would watch this video, they could find a little motivation to cooperate in solving these issues.
Check out this video, you may not know whether to laugh or cry.
Of course they highlight the issues of transparency and the challenges faced by consumers in having to work with multiple providers to get a single service.
The Healthcare Blue Book is working to solve both of these problems. Maybe if all the CEOs working in the healthcare system would watch this video, they could find a little motivation to cooperate in solving these issues.
Thursday, February 4, 2010
How Much Will Your Surgery Cost? Hospitals Can’t Tell You
Press Release regarding Healthcare Blue Book Survey: How Much Will Your Surgery Cost? Hospitals Can’t Tell You
Washington, DC. -- Patients are the losers in both the Democrat and Republican versions of the health care reform bills. Proposed health care reform won’t help patients find out how much health care costs before they get care and many hospitals aren’t set up to help.
A new research paper from The Healthcare Blue Book (www.healthcarebluebook.com) entitled Surgery Pricing Secrets: The Challenges Patients Face, shows that it is almost impossible to get prices ahead of time if a patient plans to have surgery in a hospital.
Healthcare Blue Book researchers found that:
• It took three times as many phone calls and four times as long to get pricing information from a hospital.
• Hospitals would not provide guaranteed prices and price ranges often varied by more than 100%.
• ASCs were more likely to discount prices for cash customers; regardless of the patient’s financial status.
• Facility fees are 3-4 times higher in a hospital than in an ASC.
Healthcare Blue Book researchers contacted hospitals and ambulatory care centers (ASCs) in three markets: Raleigh-Durham, NC; Denver, CO; and Portland, OR. Hospitals and ASCs were asked to provide the costs of an anterior cruciate ligament surgery of the knee for a patient without health insurance.
Queries were primarily about facility fees, but researchers also asked respondents about other fees associated with the surgery.
It’s almost certain health care expenditures, which totaled about $2.5 trillion in 2009, will continue to climb by at least 6% a year. Hospital costs are 31% of the total according to the Centers for Medicare and Medicaid Services. So what are health care consumers going to do?
The Healthcare Blue Book, an Internet content provider, offers a free consumer guide to fair pricing for healthcare treatments and services for local markets at www.healthcarebluebook.com.
“One of the main tenets of successful healthcare reform will be patients taking more responsibility for finding out what their care costs as they make treatment decisions,” said Dr. Jeffrey Rice, Healthcare Blue Book CEO, and white paper author. “But until hospitals are able to provide exact pricing, managing out of pocket costs for both insured and self-pay patients is almost impossible.”
For a free copy Surgery Pricing Secrets: The Challenges Patients Face go here.
Washington, DC. -- Patients are the losers in both the Democrat and Republican versions of the health care reform bills. Proposed health care reform won’t help patients find out how much health care costs before they get care and many hospitals aren’t set up to help.
A new research paper from The Healthcare Blue Book (www.healthcarebluebook.com) entitled Surgery Pricing Secrets: The Challenges Patients Face, shows that it is almost impossible to get prices ahead of time if a patient plans to have surgery in a hospital.
Healthcare Blue Book researchers found that:
• It took three times as many phone calls and four times as long to get pricing information from a hospital.
• Hospitals would not provide guaranteed prices and price ranges often varied by more than 100%.
• ASCs were more likely to discount prices for cash customers; regardless of the patient’s financial status.
• Facility fees are 3-4 times higher in a hospital than in an ASC.
Healthcare Blue Book researchers contacted hospitals and ambulatory care centers (ASCs) in three markets: Raleigh-Durham, NC; Denver, CO; and Portland, OR. Hospitals and ASCs were asked to provide the costs of an anterior cruciate ligament surgery of the knee for a patient without health insurance.
Queries were primarily about facility fees, but researchers also asked respondents about other fees associated with the surgery.
It’s almost certain health care expenditures, which totaled about $2.5 trillion in 2009, will continue to climb by at least 6% a year. Hospital costs are 31% of the total according to the Centers for Medicare and Medicaid Services. So what are health care consumers going to do?
The Healthcare Blue Book, an Internet content provider, offers a free consumer guide to fair pricing for healthcare treatments and services for local markets at www.healthcarebluebook.com.
“One of the main tenets of successful healthcare reform will be patients taking more responsibility for finding out what their care costs as they make treatment decisions,” said Dr. Jeffrey Rice, Healthcare Blue Book CEO, and white paper author. “But until hospitals are able to provide exact pricing, managing out of pocket costs for both insured and self-pay patients is almost impossible.”
For a free copy Surgery Pricing Secrets: The Challenges Patients Face go here.
Sunday, January 31, 2010
Cut Your Health Care Costs Now!
Cut Your Health Care Costs Now! is a new book by Brandi Funk, FNP-C that I just had the opportunity to review.
Brandi Funk is a board certified family nurse practitioner and health care advocate. With 15 years of experience helping patients, she as a lot to offer in her book.
Her book begins with suggestions for buying health insurance. Most importantly are the check lists to make sure your coverage will actually cover you.
She next shares useful tips on using your insurance. The book has lots of tips for traditional insurance and also for using Medicare. While many readers may have traditional insurance, they may also be helping their parents with issues involving Medicare.
Healthcare Blue Book is focused on helping patients get quality care at affordable prices. Cut Your Health Care Costs Now! offers many suggestions to patients on how to save on health care expenses and prescription drugs. Of course, one of my favorite tips in the book is "Negotiate Your Price First". As we see every day, once a patient gets care; it is very difficult to lower the final bill. However, patients can save $100's or even $1000's if they know to ask about prices first. Often they improve the quality of their care too.
Cut Your Health Care Costs Now! has many other tips for consumers. It is well worth your time and I imagine that most consumers will save a lot more than the book costs. A book that pays for itself, how can you beat that?
The book is provided as an e-book. One neat thing about the e-book format is the fact that you can directly link to valuable resources provided in the book. Ms. Funk has excellent reference sources, lists, and content links throughout the book.
You can find the book here.
Brandi Funk is a board certified family nurse practitioner and health care advocate. With 15 years of experience helping patients, she as a lot to offer in her book.
Her book begins with suggestions for buying health insurance. Most importantly are the check lists to make sure your coverage will actually cover you.
She next shares useful tips on using your insurance. The book has lots of tips for traditional insurance and also for using Medicare. While many readers may have traditional insurance, they may also be helping their parents with issues involving Medicare.
Healthcare Blue Book is focused on helping patients get quality care at affordable prices. Cut Your Health Care Costs Now! offers many suggestions to patients on how to save on health care expenses and prescription drugs. Of course, one of my favorite tips in the book is "Negotiate Your Price First". As we see every day, once a patient gets care; it is very difficult to lower the final bill. However, patients can save $100's or even $1000's if they know to ask about prices first. Often they improve the quality of their care too.
Cut Your Health Care Costs Now! has many other tips for consumers. It is well worth your time and I imagine that most consumers will save a lot more than the book costs. A book that pays for itself, how can you beat that?
The book is provided as an e-book. One neat thing about the e-book format is the fact that you can directly link to valuable resources provided in the book. Ms. Funk has excellent reference sources, lists, and content links throughout the book.
You can find the book here.
Monday, January 25, 2010
The People's Health Care Reform Plan
I just received an article by Dr. Bradley Hennenfent: The People's Health care Reform Plan.
The Plan starts off like this:
+++++++++++
Let's be part of the Health Care Reform solution. Let's distribute a plan that empowers patients, doctors, and nurses, which everyone can understand. The People's Health Care Reform Plan will make PATIENTS MORE POWERFUL, and the Government, corporations, and insurance companies (crony capitalism) less powerful. This plan will reduce costs, increase access, and save the most lives. It's also simple.
SHORT VERSION OF THE PEOPLE'S HEALTH CARE REFORM PLAN
1. Tell us patients what everything costs - no more secrets.
2. Give doctors, nurses, and allied health care professionals social networking so they can tell us everything they know.
3. Tort Reform.
4. Distribute The People's Health Care Reform Plan to everyone in America and around the World via Facebook, E-mail, etc.
PATIENTS GETTING CONTROL OF PRICES
Congress must facilitate that patients be told the price of everything in health care in advance, except in true emergencies, or they do not have to pay.
Patients cannot spend money from Medicare, Medicaid, Insurance Companies, Unions, or their own money, wisely if they do not know what anything costs. It's these hidden prices that cause monopolies that drive up our prices and result in unsavory backroom political deals. It's not knowing the price of anything that enables Medicare, Medicaid, and corporate fraud to occur so easily. How can we know if we are overcharged if we never know what anything costs in the first place? How can we revolutionize health care if we don't know what costs too much? We need to know the prices.
+++++++++++
The plan goes on to include aspects of getting more information to patients via technology and clinician input; tort reform; putting more power with patients and direct care providers; and finally a plan to get the plan out.
You can read the entire plan at Dr. Hennenfent's FaceBook.
It is easy to support pricing transparency and some of the other concepts in the plan. Healthcare Blue Book provides nice technology that helps patients with comparison pricing.
So what do you think about the Dr. Hennenfent's plan?
The bigger question to me, is why is it left to individuals to promote common sense solutions that would actually help reform the health system?
The Plan starts off like this:
+++++++++++
Let's be part of the Health Care Reform solution. Let's distribute a plan that empowers patients, doctors, and nurses, which everyone can understand. The People's Health Care Reform Plan will make PATIENTS MORE POWERFUL, and the Government, corporations, and insurance companies (crony capitalism) less powerful. This plan will reduce costs, increase access, and save the most lives. It's also simple.
SHORT VERSION OF THE PEOPLE'S HEALTH CARE REFORM PLAN
1. Tell us patients what everything costs - no more secrets.
2. Give doctors, nurses, and allied health care professionals social networking so they can tell us everything they know.
3. Tort Reform.
4. Distribute The People's Health Care Reform Plan to everyone in America and around the World via Facebook, E-mail, etc.
PATIENTS GETTING CONTROL OF PRICES
Congress must facilitate that patients be told the price of everything in health care in advance, except in true emergencies, or they do not have to pay.
Patients cannot spend money from Medicare, Medicaid, Insurance Companies, Unions, or their own money, wisely if they do not know what anything costs. It's these hidden prices that cause monopolies that drive up our prices and result in unsavory backroom political deals. It's not knowing the price of anything that enables Medicare, Medicaid, and corporate fraud to occur so easily. How can we know if we are overcharged if we never know what anything costs in the first place? How can we revolutionize health care if we don't know what costs too much? We need to know the prices.
+++++++++++
The plan goes on to include aspects of getting more information to patients via technology and clinician input; tort reform; putting more power with patients and direct care providers; and finally a plan to get the plan out.
You can read the entire plan at Dr. Hennenfent's FaceBook.
It is easy to support pricing transparency and some of the other concepts in the plan. Healthcare Blue Book provides nice technology that helps patients with comparison pricing.
So what do you think about the Dr. Hennenfent's plan?
The bigger question to me, is why is it left to individuals to promote common sense solutions that would actually help reform the health system?
Tuesday, January 12, 2010
Marathon Health and Healthcarebluebook.com Join Forces to Help Employers Reduce Healthcare Costs
NASHVILLE, Tenn.--Marathon Health and Healthcarebluebook.com today announced a co-marketing agreement to bring new consumer education and healthcare price transparency tools to employers with consumer directed health plans (CDHP) or high deductible health plans (HDHP).
The joint offering extends Marathon Health’s onsite clinic capabilities by helping employees with significant out of pocket expenses make informed, cost conscious decisions on treatment. Both onsite clinicians and employees will have access to the Healthcare Blue Book’s education and healthcare price transparency tool. Marathon Health clinic patients can access the Blue Book tool directly from the Marathon eHealth Portal, or work with their onsite clinician to consider treatment options, understand out of pocket costs, and make smarter, more affordable treatment choices when seeking care outside the clinic setting.
“Price shopping for healthcare services can be time consuming and frustrating,” said Marathon Health CEO Jerry Ford. “Our co-marketing agreement with Healthcare Blue Book will help us provide a virtual ‘safety net’ for the employees with high deductible plans who require greater access to cost and care details. This addition to our technology platform will ensure our patients have the information they need when making care decisions.”
The relationship enhances Marathon Health’s value proposition for employers who offer CDHPs by bringing timely consumer decision support to the point of care. The joint offering fills a recognized gap in employers’ consumer tool set, and helps both employee and employer save money through better use of their existing provider options.
“Marathon Health and Healthcarebluebook.com are innovative companies creating new models for delivering high-quality healthcare at a fair price,” said Healthcarebluebook.com CEO, Dr. Jeffrey Rice. “Joining forces will help us create systems that can benefit employers and employees through improved access to high-quality, cost-effective care.”
About Marathon Health
Marathon Health of Colchester, VT, offers a proven solution for helping employers reduce the total cost of healthcare. The Marathon Health approach integrates the best practices of onsite primary care, health assessment with risk identification, coaching and advocacy, and disease management for high cost chronic conditions. Marathon Health supports its unique model with an eHealth Portal delivering medical content, interactive diet and fitness tools, a personal health record, and an electronic medical record to manage care. www.marathon-health.com.
About the Healthcare Blue Book
Healthcarebluebook.com, headquartered in Nashville, TN, is a healthcare pricing tool that helps consumers and companies determine what fair prices are for healthcare services and treatments in their markets. The www.healthcarebluebook.com web site can be customized to employer needs by offering information that allows employees to identify lower cost and high quality providers within their existing employer-sponsored health plan.
The joint offering extends Marathon Health’s onsite clinic capabilities by helping employees with significant out of pocket expenses make informed, cost conscious decisions on treatment. Both onsite clinicians and employees will have access to the Healthcare Blue Book’s education and healthcare price transparency tool. Marathon Health clinic patients can access the Blue Book tool directly from the Marathon eHealth Portal, or work with their onsite clinician to consider treatment options, understand out of pocket costs, and make smarter, more affordable treatment choices when seeking care outside the clinic setting.
“Price shopping for healthcare services can be time consuming and frustrating,” said Marathon Health CEO Jerry Ford. “Our co-marketing agreement with Healthcare Blue Book will help us provide a virtual ‘safety net’ for the employees with high deductible plans who require greater access to cost and care details. This addition to our technology platform will ensure our patients have the information they need when making care decisions.”
The relationship enhances Marathon Health’s value proposition for employers who offer CDHPs by bringing timely consumer decision support to the point of care. The joint offering fills a recognized gap in employers’ consumer tool set, and helps both employee and employer save money through better use of their existing provider options.
“Marathon Health and Healthcarebluebook.com are innovative companies creating new models for delivering high-quality healthcare at a fair price,” said Healthcarebluebook.com CEO, Dr. Jeffrey Rice. “Joining forces will help us create systems that can benefit employers and employees through improved access to high-quality, cost-effective care.”
About Marathon Health
Marathon Health of Colchester, VT, offers a proven solution for helping employers reduce the total cost of healthcare. The Marathon Health approach integrates the best practices of onsite primary care, health assessment with risk identification, coaching and advocacy, and disease management for high cost chronic conditions. Marathon Health supports its unique model with an eHealth Portal delivering medical content, interactive diet and fitness tools, a personal health record, and an electronic medical record to manage care. www.marathon-health.com.
About the Healthcare Blue Book
Healthcarebluebook.com, headquartered in Nashville, TN, is a healthcare pricing tool that helps consumers and companies determine what fair prices are for healthcare services and treatments in their markets. The www.healthcarebluebook.com web site can be customized to employer needs by offering information that allows employees to identify lower cost and high quality providers within their existing employer-sponsored health plan.
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