A new website promises to provide pricing transparency to Minnesota residents.
The site can be found at www.mnhealthscores.org and is offered by MN Community Measurement.
It primarily focuses on primary care services covering office visits, minor procedures and surgeries, labs, mental health and obstetrics. Just over 100 providers are listed in the new service.
The site is generally better and more informative that most state's pricing transparency efforts. The information includes specific provider pricing information such as the average price and the range of prices for each provider based upon what they typically charge insured patients.
For a list of other state specific sites see Healthcare Blue Book.
I can recommend that Minnesota consumers use this site, but they must remain aware that the prices provided are not a guarantee of the actual price patients will pay. Consumers must still make sure they request specific pricing prior to receiving services. Consumers can get free tips on how to discuss pricing with their doctors at Healthcare Blue Book.
Thursday, August 27, 2009
Wednesday, August 19, 2009
Americans can agree on many healthcare reforms
Recently John Mackey wrote a thought provoking editorial in the Wall Street Journal- The Whole Foods Alternative to ObamaCare
While some take issue with his suggestions for health reform, it is nice to hear an alternative to the assumption in Washington that the government can or should solve every problem by increasing the federal government’s involvement in personal and local issues.
Of course we need some health reforms, but the current proposal lacks many opportunities for improvement that the vast majority of the American people would support.
To name three easy ones addressed in Mackey’s article:
Pricing Transparency- What American would argue for a system that allows some patients to be charged 3, 5 or even 10 times more than the next patient for the same service at the same location? Who would support a system that allows hospitals to charge those without any insurance much more than those with insurance? The government doesn’t need to set prices; that would rightly offend many Americans as limiting the markets or freedoms. But there should be broad public support for pricing transparency so that patients will know how much healthcare services will cost and a simple rule that hospitals will charge all patients the same price.
Equal tax treatment for health insurance- What Americans would vote against allowing individuals to deduct their health insurance but allow companies to do so? The vast majority would support equalizing the tax laws so that employer-provided health insurance and individually owned health insurance have the same tax benefits.
Tort Reform- What American would vote against tort reform? The lawyers, sure. Anyone else? So let’s say 85% support for this one. Are the politicians listening to the people? No, they left this out too.
Since the politicians are leaving out the easy improvements that most voters would support, we have to ask ourselves who are the politicians listening to? If not the voters, then maybe the lobbyist? Big business?
With a 1000+ page bill, they ought to be able to find room for the simple things that most Americans would support.
Keep the dialogue going, maybe at some point the politicians will listen.
While some take issue with his suggestions for health reform, it is nice to hear an alternative to the assumption in Washington that the government can or should solve every problem by increasing the federal government’s involvement in personal and local issues.
Of course we need some health reforms, but the current proposal lacks many opportunities for improvement that the vast majority of the American people would support.
To name three easy ones addressed in Mackey’s article:
Pricing Transparency- What American would argue for a system that allows some patients to be charged 3, 5 or even 10 times more than the next patient for the same service at the same location? Who would support a system that allows hospitals to charge those without any insurance much more than those with insurance? The government doesn’t need to set prices; that would rightly offend many Americans as limiting the markets or freedoms. But there should be broad public support for pricing transparency so that patients will know how much healthcare services will cost and a simple rule that hospitals will charge all patients the same price.
Equal tax treatment for health insurance- What Americans would vote against allowing individuals to deduct their health insurance but allow companies to do so? The vast majority would support equalizing the tax laws so that employer-provided health insurance and individually owned health insurance have the same tax benefits.
Tort Reform- What American would vote against tort reform? The lawyers, sure. Anyone else? So let’s say 85% support for this one. Are the politicians listening to the people? No, they left this out too.
Since the politicians are leaving out the easy improvements that most voters would support, we have to ask ourselves who are the politicians listening to? If not the voters, then maybe the lobbyist? Big business?
With a 1000+ page bill, they ought to be able to find room for the simple things that most Americans would support.
Keep the dialogue going, maybe at some point the politicians will listen.
Friday, July 31, 2009
The Public Option
President Obama is championing a "Public Option" to offer insurance to Americans. The government's Public Option is proposed to give Americans more choices and pressure traditional insurance companies to do better. Obama has stated that the Public Option would compete fairly with the private insurers on a "level field".
We all need to evaluate this issue. If the Public Option is subsidized by the government, then it will offer 'cheaper' premiums - even if its costs are really higher. If people can buy a government subsidized Public Option that may cover more with lower premiums, then how will private insurers survive? They won't over time.
So will the Public Option use the government's power to compete on a "level field" with private insurance?
Let's make this simple. One proposal states that the Public Option would pay healthcare providers 105% of Medicare rates. However, a Federal Court in Florida recently ruled that a private insurer must pay 239% of Medicare rates to providers. The Federal Court found that 239% of Medicare rates was fair and a reasonable market rate to pay providers. See Weinberger, et al v. Aetna Health, Inc., No. 1:2006-cv-20249).
So let's stop there. The Public Option will pay less than 50% of a fair market rate.
Is there any way the Public Option can be championed as another market based insurance alternative competing on a level field?
What will happen to private insurance as an option?
Where is the mature, responsible and thoughtful health reform we need?
We all need to evaluate this issue. If the Public Option is subsidized by the government, then it will offer 'cheaper' premiums - even if its costs are really higher. If people can buy a government subsidized Public Option that may cover more with lower premiums, then how will private insurers survive? They won't over time.
So will the Public Option use the government's power to compete on a "level field" with private insurance?
Let's make this simple. One proposal states that the Public Option would pay healthcare providers 105% of Medicare rates. However, a Federal Court in Florida recently ruled that a private insurer must pay 239% of Medicare rates to providers. The Federal Court found that 239% of Medicare rates was fair and a reasonable market rate to pay providers. See Weinberger, et al v. Aetna Health, Inc., No. 1:2006-cv-20249).
So let's stop there. The Public Option will pay less than 50% of a fair market rate.
Is there any way the Public Option can be championed as another market based insurance alternative competing on a level field?
What will happen to private insurance as an option?
Where is the mature, responsible and thoughtful health reform we need?
Monday, July 20, 2009
Obama speaks out on health reform: Do his words match the reality?
The President just gave a pep talk for health reform but most of the speech was at odds with what is actually being proposed in the 'reform' legislation.
"The healthcare system is breaking families and businesses" but the current reform proposal doesn't include any major reforms that would decrease costs. In fact, the CBO estimates that costs are likely to GO UP under the current proposed reform.
And while our families and business are being financially broken, the current proposal adds taxes on families (only on the 'rich', maybe) and an unfunded mandate on business or an 8% tax on wages. Obviously increasing costs on families and business will not lower their costs. Did i miss something??
The President stated that we "cannot put off the hard work" required to achieve healthcare reform. But this is the biggest contradiction going. Clearly there are reforms that can help the healthcare system and the insurance system. They may even receive bipartisan support and public acceptance. But the current proposal is not the result of 'hard work'; it is a plan to spend money we don't have on a system that doesn't provide good value in the first place.
A proposal that simply spends money we don't have or make others spend money they don't have is immature and irresponsible. It is 'reform' for the headlines; not for the patients.
Absent from the entire conversation and proposal are the details that call for personal responsibility in the healthcare system, whether it is taking care of one's health or spending money wisely on necessary services. Clearly that is where the reform needs to start. The system is too expensive primarily because there is little personal accountability today. It will take a thoughtful, mature, and responsible leader to accomplish this. I hope the President or someone in Congress will step up to the challenge.
"The healthcare system is breaking families and businesses" but the current reform proposal doesn't include any major reforms that would decrease costs. In fact, the CBO estimates that costs are likely to GO UP under the current proposed reform.
And while our families and business are being financially broken, the current proposal adds taxes on families (only on the 'rich', maybe) and an unfunded mandate on business or an 8% tax on wages. Obviously increasing costs on families and business will not lower their costs. Did i miss something??
The President stated that we "cannot put off the hard work" required to achieve healthcare reform. But this is the biggest contradiction going. Clearly there are reforms that can help the healthcare system and the insurance system. They may even receive bipartisan support and public acceptance. But the current proposal is not the result of 'hard work'; it is a plan to spend money we don't have on a system that doesn't provide good value in the first place.
A proposal that simply spends money we don't have or make others spend money they don't have is immature and irresponsible. It is 'reform' for the headlines; not for the patients.
Absent from the entire conversation and proposal are the details that call for personal responsibility in the healthcare system, whether it is taking care of one's health or spending money wisely on necessary services. Clearly that is where the reform needs to start. The system is too expensive primarily because there is little personal accountability today. It will take a thoughtful, mature, and responsible leader to accomplish this. I hope the President or someone in Congress will step up to the challenge.
Tuesday, June 23, 2009
Quality and Cost: Do you get what you pay for?
As we buy many products and services, we expect to get better quality if we are asked to pay a higher price. The new sports car is obviously more expensive and better quality than the used clunker. Of course we probably check consumer reports and other ratings before we buy just to be sure. We know high price doesn't guarantee that something is high quality. In other situations we may pay more just for the brand.
What about healthcare? Does paying more mean you are going to get higher quality?
Health Affairs published a nice study examining this issue. They looked at quality indicators and costs at specific hospitals. The bottom line: they found that many quality indicators did not improve with increasing costs and for others the quality went down at the more expensive hospitals. There were not any examples of higher quality resulting from higher costs. They also did analysis on the "Brand" issue in healthcare by looking specifically at academic medical centers. Increased costs at those centers did not add to quality either.
While the issues are complex and this study only examined a small set of clinical situations; consumers should realize that finding quality care requires careful research. And consumers should not assume that expensive providers or brand name providers have good quality. According to this study, and others, the opposite may be closer to the truth.
For useful links to quality ratings of providers, consumers can check out the Resources for Patients section at the Healthcare Blue Book.
The Health Affairs article at: Health Affairs 28, no. 4 (2009): w566–w572 (published online 21 May 2009)
What about healthcare? Does paying more mean you are going to get higher quality?
Health Affairs published a nice study examining this issue. They looked at quality indicators and costs at specific hospitals. The bottom line: they found that many quality indicators did not improve with increasing costs and for others the quality went down at the more expensive hospitals. There were not any examples of higher quality resulting from higher costs. They also did analysis on the "Brand" issue in healthcare by looking specifically at academic medical centers. Increased costs at those centers did not add to quality either.
While the issues are complex and this study only examined a small set of clinical situations; consumers should realize that finding quality care requires careful research. And consumers should not assume that expensive providers or brand name providers have good quality. According to this study, and others, the opposite may be closer to the truth.
For useful links to quality ratings of providers, consumers can check out the Resources for Patients section at the Healthcare Blue Book.
The Health Affairs article at: Health Affairs 28, no. 4 (2009): w566–w572 (published online 21 May 2009)
Wednesday, June 10, 2009
ACE Pilot for Consumerism and Value Based Purchasing
A new demonstration project from CMS will provide patients with financial incentives to qualifying Medicare patients who select a health care provider based on quality and price.
As part of the Acute Care Episode (ACE) demonstration, five regional health systems nationwide have been designated Value-Based Care Centers. These centers will provide select cardiac and orthopedic services to Medicare beneficiaries at discounted rates.
CMS will share a portion of their savings with patients.
You can see an article on this at the Oklahoman paper.
This is a very interesting pilot.
It should give encouragement to other privately insured organizations that are exploring similar incentives.
As part of the Acute Care Episode (ACE) demonstration, five regional health systems nationwide have been designated Value-Based Care Centers. These centers will provide select cardiac and orthopedic services to Medicare beneficiaries at discounted rates.
CMS will share a portion of their savings with patients.
You can see an article on this at the Oklahoman paper.
This is a very interesting pilot.
It should give encouragement to other privately insured organizations that are exploring similar incentives.
Sunday, May 31, 2009
101 Ways To The Best Medical Care
I just had an opportunity to read an interesting book titled "101 Ways To The Best Medical Care" written by Charlotte E. Thompson, MD.
The subtitle is "The medical guide that could save your life". Since patients don't have transparency in healthcare quality information and there are so many medical quality issues, that statement may be true for some readers. If you have to be admitted to the hospital, have a challenging clinical issue or simply "fall through the cracks"; your life could be at risk. Each patient needs to take an active role in their care to protect their health and safety. Books like this one can give patients some ideas to consider.
The book is very wide ranging; covering topics from clinical issues (doctors, hospitals, emergencies) to Insurance (medicare, overseas) to administrative (medical records, etc.). While not every chapter will apply to each person, it is likely that many chapters will be useful to most patients.
The chapters on finding a different doctor, getting the best care and becoming informed were very useful. The chapter on hospital care was also a gem - warning of teaching hospitals, nursing shortage and what patients should do.
Given the breadth of the book it isn't surprising that I would take a different approach or view on some of the advice. While I agree that using the yellow pages to find a doctor won't give you any useful quality information; I'm not sure asking friends will be much better. Quality information needs to come from qualified and trusted sources. I always recommend checking federal and state websites when available.
And the statement "you usually get what you pay for" on page 8 is definitely not what I have found in my research on healthcare quality and pricing. At best there is no definitive link between cost of care and quality of care; and some evidence draws the opposite conclusion: higher quality care can cost less than poor quality care. See Health Affairs just this Month- Hospital Quality And Intensity Of Spending: Is There An Association?
While I see a few things differently, I congratulate Dr. Thompson on her efforts and her book. It has some great advice that should help many patients.
The subtitle is "The medical guide that could save your life". Since patients don't have transparency in healthcare quality information and there are so many medical quality issues, that statement may be true for some readers. If you have to be admitted to the hospital, have a challenging clinical issue or simply "fall through the cracks"; your life could be at risk. Each patient needs to take an active role in their care to protect their health and safety. Books like this one can give patients some ideas to consider.
The book is very wide ranging; covering topics from clinical issues (doctors, hospitals, emergencies) to Insurance (medicare, overseas) to administrative (medical records, etc.). While not every chapter will apply to each person, it is likely that many chapters will be useful to most patients.
The chapters on finding a different doctor, getting the best care and becoming informed were very useful. The chapter on hospital care was also a gem - warning of teaching hospitals, nursing shortage and what patients should do.
Given the breadth of the book it isn't surprising that I would take a different approach or view on some of the advice. While I agree that using the yellow pages to find a doctor won't give you any useful quality information; I'm not sure asking friends will be much better. Quality information needs to come from qualified and trusted sources. I always recommend checking federal and state websites when available.
And the statement "you usually get what you pay for" on page 8 is definitely not what I have found in my research on healthcare quality and pricing. At best there is no definitive link between cost of care and quality of care; and some evidence draws the opposite conclusion: higher quality care can cost less than poor quality care. See Health Affairs just this Month- Hospital Quality And Intensity Of Spending: Is There An Association?
While I see a few things differently, I congratulate Dr. Thompson on her efforts and her book. It has some great advice that should help many patients.
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