New Patient-Oriented Medical Insurance Websites Could Make Finding Affordable Health Care Easier
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Websites offering price comparisons of medical services at various hospitals have been in development since 2006. Researchers at Veterans Affairs Ann Arbor Healthcare System felt that no one really knew what was on these websites and if they were helpful at all. And so, they set out to describe the characteristics of health care price transparency websites in order to identify ways to make them more useful for consumers.
From January to May 2012, researchers looked for all of these websites and noted what information they were providing. They found that there were 62 of them as of 2012, but half had launched since 2006. Many websites were begun by a hospital association or government agency. The reported prices reflect charges that are billed to insurance companies, but few estimates take into account a patient's insurance status or health care plan.
Most information provided was for procedures that were predictable, nonurgent, did not require additional lab work that could create additional fees, and subject to insurance deductibles. Care like this includes follow-up appointments for chronic illnesses like diabetes or psoriasis, planned elective surgeries, and screening procedures for breast cancer or HIV/AIDS. The plus side to all of this is that comparisons could be made based on actual dollar amounts assigned to each health care service by various hospitals or doctors.
Predictable or nonurgent care can get surprisingly expensive if patients are not informed of the price of each visit. Often, insurance companies will only cover a certain number of visits per year, leaving patients to deal with the financial burden of extra visits. Just as often, doctor visits need to be made; pre- and post-surgical follow-ups, regular doctor visits, and screening for diseases and disorders are the most common visits that can rack up in price if patients are not careful. These websites can prevent patients from overspending at some facilities, as they outline the hospitals in which each service can be performed, as well as the price for each.
This study was done to examine what kind of information was available to patients. Although there are so few of these websites, and they provide limited information, the pieces of information they do provide is significantly helpful to patients who are planning a procedure and want to ensure that their insurance will cover their entire visit. This sort of transparency, on the part of health care providers, allows patients to get the most value out of their health care spending.
Jeffrey T. Kullgren, M.D., M.S., M.P.H., leader of this study, wrote in the report, "With rising health care costs and 30 percent of privately insured adults enrolled in high-deductible health care plans, calls for greater health care price transparency are increasing. In response, health plans, consumer groups, and state governments are increasingly reporting health care prices."
"Despite recognition that price information must be relevant, accurate, and usable to improve the value of patients' out-of-pocket expenditures, and the potential for this reporting to affect health care organizations and prices, there are no data on what kind of price information is being reported," he added. Kullgren stresses that providing the information and providing true information are equally important.
However, in a world where everyone needs health care, there are some critiques about the usefulness of these sites. Dr. Frederick Licciardi, M.D. of the NYU Fertility Center at NYU's School of Medicine, when asked his opinion regarding these sites, said, "At this point there is not much difference in the care given by a cheaper [or a] more expensive doctor. Some doctors in some fields do not take any insurance, but that does not mean they are better." He added that patients should still discuss medical decisions with their health care providers. Licciardi said, "It makes for a nice mystique, but it may just a facade," Licciardi said, regarding these websites.
Source: Kullgren JT, Duey KA, Werner RM. A Census of State Health Care Price Transparency Websites. JAMA. 2013.