Cost of Medical Care
Haircuts. Houses. Plane tickets. Computers. Ever bought any of these things without knowing the price beforehand, and then just paid the bill after?
Chances are not, you probably checked sites like Amazon or Expedia first.
But Jeanne Pinder, founder of the startup ClearHealthCosts.com, says that's how health care works.
"Nobody has any idea what things cost," she says.
The Pulse is now launching a new project called WHYY PriceCheck, in partnership with Pinder's company. The idea is to build a crowdsourced database of prices for common medical procedures here in the Delaware Valley.
Pinder, a self described careful shopper who used to be with the New York Times, started ClearHealthCosts.com in 2011 with the goal of making prices more transparent. Since then, the company has been building a searchable database of price information for about three dozen common medical procedures.
Think mammograms, vasectomy, birth control pills, colonoscopies...the list goes on.
How WHYY PriceCheck works
To get a handle on costs in a region, Pinder's group crunches Medicare data. They survey hospitals, providers and insurers directly for their self pay charges.
That information, however, can be really hard to get, and it's inconsistent.
Which is where individuals come in. The crux of this database comes from crowdsourced information people provide from the bills or insurance statements they received for medical procedures.
Pinder did trial runs in partnership with public radio stations in New York and California (scroll down for more details on the California project) and has been finding that prices for the very same medical procedure may vary, up to tenfold, from practice to practice.
"For most of us, we have the impression prices are more or less uniform or perhaps that they're regulated," says Pinder. "Most people are shocked when they get these gotcha bills, even for routine things like a colonoscopy or mammogram."
Other research echoes this, and early returns on Clear Health Costs' research in the Philadelphia region shows big variations. A cardio test, for example, was priced at $80 at one facility and $500 at another.
It's a big problem, Pinder says, as people are bearing a greater brunt of health care costs through health plans with higher deductibles and out of pocket spending.
To make prices more transparent, we need your help
WHYY PriceCheck is a little different from The Pulse's typical reporting approach, but to make this project a success in this region, we need your help.
We've created an online form and database that makes it easy for you to confidentially share what you paid for health services and in turn, make apples-to-apples comparisons of prices.
All it takes is completing the simple form. If you have insurance, you'll need your explanation of benefits.
The Pulse's created a video to walk you through it.
The form is designed to accept many kinds of medical tests and procedures, but to start things off, we're especially interested in prices charged and paid for mammograms and colonoscopies.
"They're fairly common procedures," says Pinder.
While we realize that health care costs are complicated and that prices are not straightforward, the hope is through crowdsourcing your experiences and doing more reporting in the coming months, we'll all gain a better understanding of health care costs in this region and a better idea of what things cost, before going in for that procedure.
Have questions or want to share a story? Email us at firstname.lastname@example.org or call 267-225-7299.
Real results in California
Last June, public media outlets KQED and KPCC partnered with ClearHealthCosts.com to launch a price transparency project in California, focusing on the San Francisco bay area and Los Angeles.
Since then, KQED health editor Lisa Aliferis said hundreds of people have submitted their charges for common medical procedures and thousands have searched the database.
"When we launched we kind of held our breath," Aliferis said, "and we've been delighted by the response we've gotten."
The radio stations aired call-outs for prices from four common medical procedures: mammograms, lower-back MRIs, intrauterine devices (IUDs) and diabetes test strips.
What they found: a huge variation in costs paid by insurers from facility to facility.
Mammograms ranged from $128 to $694, and lower-back MRIs from $470 to $1550.
One consumer with a high deductible health plan commented on the site that he was quoted a price of $1,850 for a procedure at first, and then when he offered to pay cash up front, the price was dropped to $580, Aliferis said.
"A provider is not supposed to let someone pay cash, they are supposed to insist on the insured price, patients are not supposed to do that either," Aliferis said.
It is often difficult to pin down prices before a procedure, but Aliferis argues patients should always pose the question.
"There is money to be saved out there if patients or consumers think to ask," she said.