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.

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.

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.