There's one question in health care that hardly anyone will ever answer.
It's not "Will it hurt?" Or even, "How long will I live?"
It's even more basic: "How much will it cost?
For years, people with health insurance and low co-pays have paid little attention to the question of cost.
But as the employee's share of the bill has gone up, and as more people realize their healthcare costs are rising, there's increased interest -- and need -- for a better understanding of charges.
Average deductibles are going up all the time. Co-insurance rates -- the percentage of the bill that you have to pay -- are typically between 20% and 40%. Many of us want to use the doctor of our choice, rather than go to someone just because they're in our "network," as long as we can keep the cost down. And some services just aren't covered by insurance.
Complicating things is the fact that we typically have some options about what treatment or procedure we get -- and where -- and we often want to know the relative value of the choices we make.
I've just stumbled upon a promising resource you might want to try. It's called Healthcare Blue Book.
Healthcare Blue Book is a free guide to healthcare pricing. It also offers guidelines about how to negotiate price and information for those of us who want to get our out-of-pocket costs down.
Just as cars have a blue book price, doctor visits, medical tests, treatments, procedures and surgeries have average insurance-paid and self-paid prices in every zip code.
The blue book price is calculated based on industry data from many providers, payers and employers across the country. The information is analyzed to identify the dollar amount that many providers accept as payment in full.
You can compare prices in a wide range of categories, from physicians' services to surgeries, dentistry, lab tests and even hearing aids. Interested in comparing the cost of cosmetic surgery in different towns or where you live? Check it out.
According to Healthcare Blue Book:"Blue book prices are generally much lower than billed charges. Hospitals and doctors keep track of their services with two different fee schedules: 1) billed charges and 2)negotiated rates. While providers are generally able to set billed charges to whatever amount they would like, they typically have a range of acceptable negotiated payment rates that they agree to accept as payment in full from insurance companies."
If you're a cash paying customer, you may ask your hospital or doctor to charge you a fair price.
If you don't have health insurance, you can call a doctor, hospital or laboratory and see if they offer discounts for self-pay patients. If you have insurance, ask the in-network providers listed in your directory what the in-network rate is for the service you need.
Sometimes, just by traveling to a nearby town you can save money. Healthcare Blue Book says that some imaging centers charge three to five times more than others. This is true for both patients using insurance networks and those paying cash.
Here's something I tried on the site. I was wondering what a knee MRI (with and without contrast media) would cost. I compared the charge between two locations. Here's what I found comparing the two cities:
In the more urban community, the cost was $1,006.
In the less urban town, the cost was $866.
What about quality factors? Cost and quality are not always linked. Just because a healthcare service, procedure or test is priced higher, it doesn't necessarily mean the professionals, equipment, or outcomes are better.
This is just the beginning. Gradually we'll have the data we need to make truly informed choices that allow us to figure in cost, quality, risk and benefit before we make a significant healthcare decision for ourselves or our family.
Barbara Bronson Gray, RN, MN, is the founder of the blog www.bodboss.com, which is “dedicated to helping people learn to be the CEO of their own body and better guide their own health care.” Besides her hands-on work as both a nurse and supervisor in hospitals, Barbara has written articles that have been published in a number of national magazines and newspapers. Follow her on Twitter: @bbgrayrn.
