How do I find the cost of outpatient medical services?
One of the proposed strategies to slow down the increasing cost of medical services is to get more people into consumer directed high deductible health plans (CDHP), which can also be health savings accounts. The theory is that when people have to shop and compare for medical services, because they are responsible for a higher deductible before certain medical benefits are covered, they will select lower cost providers rewarding efficiency.
As I have written before, this all sounds good until you have to actually go out in the market place and shop for medical services.[HSA's Aren't for Everyone] Hospitals and doctors really don’t want to provide quotes because there are so many unknowns such as your specific health insurance, the variety of possible procedures and billing codes.
Consequently, I was intrigued when I heard that Anthem Blue Cross had a cost comparison website for different medical procedures. I decided to take a tour and see how easy it was to find cost estimates for various procedures in the Sacramento-Roseville region of northern California. My searches were centered on the type of out-patient services a family might encounter in non-emergency situations.
I was able to access the website through my Anthem Blue Cross Agent Portal. I am not sure if the site is available to people who are not plan members of Anthem Blue Cross. Upon first entry I was surprised to learn that it looks like the site is powered by WebMD. After I got passed the first page of accepting the terms and conditions, the WebMD logo never showed up again. But you will notice the web address is linked to WebMD as you proceed.
It makes sense that a major insurance company would partner with an internet application like WebMD because of their existing experience and content on medical issue. We can only hope there is little to no sharing of consumer information. I would hate for my wife to be alerted in some email that I had been looking at the cost of baby delivery when we are long past that stage.
Navigation and drill down to select a particular procedure is pretty easy. The human body image allows you to select different body parts, front/back, male/female, and then gives you pop ups for further selection. Although, I could not find vasectomy under procedures, liposuction was easily found.
A perennial question I get is, “How much is a routine office visit?” So I selected the comparison for office visits to see what popped up.
The report showed an average cost of between $71 and $130 dependent on the length and type of exam. That pretty much is in line with what I have heard. Although, it doesn’t tell you from what physician groups it is pulling the data from.
With sports injuries common in California I wanted to compare costs for the typical injury us older guys sustain playing football, rugby and basketball; the dreaded knee injury. Of course, before the doctor prescribes a medical procedure to fix the knee he has to see the knee. He sends you to get a MRI.
If this report is anywhere near accurate, you don’t even want to get close to a hospital for a MRI. The typical high cost for an MRI from a local imaging facility is $517, while the hospitals of UC Davis and Mercy start in the low $2,000. At those prices your insurance company could chauffeur you to one of the stand alone imaging companies and still be money ahead over what the hospitals charge.
Your doctor saw the MRI and has determined you need arthroscopic knee surgery before you can get out on the rugby field again.
Wow, another round of sticker shock comparisons. I have always believed that you get what you pay for. But I am having a hard time understanding the $9,300 cost difference between the South Placer Surgery Center and Mercy Hospital of Folsom. The hospital pricing, similar to the MRI, is twice as much as a surgery center. Arthroscopic surgery is out-patient so the hospital price certainly doesn’t include a nights stay with fine hospital food.
Now that your knee is fixed, but remember I couldn’t find any prices for vasectomies, you want to start a family. How much will a hospital birth be for the new family member?
It looks like some hospitals value the delivery of a baby only slightly more than arthroscopic surgery for your knee. These are not the prices for a cesarean delivery. My first thought was, “Why aren’t there private birthing centers like there are for MRI’s and out-patient surgery?” We have to remember that only certain providers that Anthem Blue Cross contracts with will show up in the reports. Notice that none of the Sutter hospitals or medical centers have shown up in the cost comparison.
My final search was for breast cancer needle biopsy costs. While cancer services aren’t necessarily something you shop around for, I had been surprised at the wide disparity in costs for the previous procedures.
Alas, only two providers showed up with no cost estimates. Perhaps they haven’t refreshed the data or there are to few procedures to get an estimate. Either way, it shows some of the weakness of the system.
Overall I was impressed with the cost comparison estimates. To be fair to the hospitals, we don’t know if their costs are more comprehensive and might include items such anesthesia, bandages, hazardous waste disposal fees, etc. that the local smaller surgery centers have not included. The cost comparison system isn’t perfect but it is a start to getting consumers the information they need to make informed choices about their healthcare services.