Finding accurate healthcare cost information remains
difficult; there is no comprehensive database of prices When Vicki Burns was
told she needed total hip replacement surgery in 2012 she asked her local
hospital for a cash price. She got a $79,000 estimate for the surgery. A doctor
advised her to research the fee that the hospital accepts from Medicare and use
that as a starting point. Her husband gathered the data and tried to negotiate.
Desperate for an alternative, the New Mexico couple took to
the Internet and found a Tennessee website they liked called MediBid. For $4.95
a month or $25 for a year of unlimited requests, patients can post the medical
services they need, and doctors bid for their business. The prices included her
hospital stay, the anesthesiologist, pre-operative tests and post-surgical
visits. She settled on a surgeon in Glendale who offered to operate for
$13,400. Including the cost of traveling to California, she figures she spent
$18,000 for the surgery she got in 2012.
MediBid, which has been in business since 2010, has returned
up to 17 bids from doctors nationwide for knee replacement surgeries and often
six or seven for common procedures, such as colonoscopies, says founder and
Chief Executive Ralph Weber. Dr. Peter LePort, a general surgeon practicing in
Fountain Valley, participates with MediBid. He says he's seen a rise in the
number of patients with high-deductible health plans looking for cheaper
alternatives. Paying cash instead of using insurance often helps them get lower
prices. With rising out-of-pocket expenses, patients are increasingly demanding
information about price and quality that historically has been unavailable.
Entrepreneurs, states and employers now offer such tools. A
number of newly formed coalitions made up of insurers, pharmaceutical companies
and other industry insiders are also vowing to push for the release of price
information long held as trade secrets.
San Francisco-based Pokitdok (pokitdok.com), co-founded by
CEO Lisa Maki in 2011, operates in 44 markets, including Los Angeles. You can
search the 50 most shopped medical procedures among 40,000 providers who have
submitted their cash price. If you upload your insurance information, PokitDok
will tell you if it's cheaper for you to pay cash or use your insurance policy.
Insurance claims can be submitted through the site. You can also make an
appointment to see a doctor.
New shopping tools like these frequently enter the market,
and established ones are constantly evolving. Still, finding accurate
healthcare cost information generally remains difficult, and there is no
comprehensive database of healthcare prices. Experts have identified a few
things to consider when comparing healthcare prices. Most pricing tools have at
least some token quality information, though not typically displayed in ways
likely to help consumers easily compare choices.
Understand your health plan. You need more information
than a simple dollar amount. To really know how much you're likely to pay for
care, you need to understand what your insurance pays for, how much of your
deductible you've satisfied, and any other out-of-pocket costs your plan
requires you to pay. Read the fine print. Pricing data vary widely from
website to website, making apples-to-apples comparisons a challenge.
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