By Lisa Zamosky
In 2011, nearly 30 million Americans were enrolled in a high-deductible health plan with at least a $1,000 deductible for individuals and $2,000 for families, according to the Employee Benefit Research Institute. That’s almost double the number of people who had this type of coverage just six years ago.
As the number of people with high-deductible health plans rises, so too does the need to understand the true cost of our health care.
The fact is there is wide variation in price for medical procedures. It just depends upon where the care is delivered (and price seems to have no relationship to the quality of medical care delivered). This is a phenomenon that’s been demonstrated many times over in survey after survey of the health care market. One of the more recent stories on the topic appeared last week in USAToday,which wrote about a recent survey showing that the cost of common preventive health services, such as colonoscopies, varied by as much as 700% depending upon where the care was delivered.
Tools for Negotiating
I’ve talked before on this blog about how to negotiate for better health care prices as well as the importance of carefully considering the location at which you access medical care. Generally speaking, freestanding labs or surgery centers are less expensive than hospitals, urgent care centers are far cheaper than the emergency room, and you’ll pay less for routine check-ups at a walk-in medical clinic than at your doctor’s office.
I’ve also written before about how, despite the growing pressure on consumers to shop for healthcare prices, the true cost of care can be hard to uncover, no matter how hard you try.
Still, despite the many existing road blocks, there’s no doubt that it pays to shop around.
Online Pricing Resources
There are a growing number of resources available to consumers interested in learning about a fair price for a particular medical procedure before they step into the doctor’s office. Here are a few:
Fair Health allows you to punch in your zip code to find the average cost of specific medical procedures in your area.
Pricedoc.com enables you to locate a provider nearby and then ask for a price quote via the website. You’ll be asked to provide your name, email address, and phone number so the doctor can get in touch with you directly.
HealthcareBluebook.com provides users with an online guide to a fair price for the procedure you need in your geographic area.
Hospital Compare is an online tool offered by the U.S. Department of Health and Human Services, which provides data on Medicare payments for some common procedures. People with private insurance, however, need to add 25% to 50% to determine a realistic price.
Consumerhealthratings.com provides a number of state-specific resources for learning the price of medical procedures.
And many insurance companies, including Aetna, Cigna, some of the Blue plans, and United Health also offer members pricing tools on their websites.
What’s more, insurers and employers are increasingly offering incentive programs (some of which will pay you cash) as a way of encouraging consumers to choose less expensive sites for care. If you work for a mid-to-large sized company, your employer may offer tools to help employees access health care at the best possible price.
It’s critical to compare apples to apples when searching online for medical prices. Make sure you obtain what’s called a CPT code — or common procedural terminology — for the service you’re seeking. These are the codes doctors and hospitals use to bill your insurer. You can get the code by calling your insurance company.
Also be sure that you’re capturing all the costs associated with a procedure. For example, a routine colonoscopy may cost $800 but that doesn’t include the cost of the anesthesiologist if you choose to be unconscious for the procedure.
Share what you know: Have you shopped for prices before getting medical treatment? If so, were you successful in nailing down the true cost of the procedure, or were you surprised by an unexpected bill afterward?
Share your experience, plus any online pricing tools you know of that I failed to mention in the comments section.