A new law went into effect January 1 in Massachusetts. Doctors and hospitals are required to tell patients who ask how much a procedure will cost.
Unlike most other goods or services, it is extremely difficult to compare the prices of healthcare procedures. Most facilities are unable to calculate exactly how much a patient will pay for any given procedure.
This article from WBUR.org focuses on Caroline Collins. She and her husband have a health plan with a $3,000 deductible for a vaginal birth. She called various hospitals in order to determine the cost of the procedure. After many frustrating transfers and dead ends, she was finally able to determine an average price for vaginal birth at between $10,000 and $16,000.
Collins is used to the challenge of searching for health care prices because she was uninsured for a while in her 20s. So does she feel like anything has changed now that hospitals and doctors are required to quote patients a price within two working days?
“The experience was pretty frustrating from beginning to end,” she says. “It was definitely surprising how many machines I spoke to within the last few days.”
This is the world in which Collins is supposed to become a savvy health care consumer, making informed decisions about where to get the best care at the best price.
Here is why it's difficult for the hospitals:
No one said this would be easy. Each hospital negotiates prices with each insurer. Sometimes the hospital and physician charges are separate, sometimes they are not. And then, what the patient pays on top of their premium varies if they have a deductible or coinsurance.
“It’s very different from, you go into Best Buy, you want to buy a refrigerator,” says Karen Granoff, the senior director for managed care at the Massachusetts Hospital Association. Granoff says her members are working with insurers to nail down prices that hospitals can quote patients.
“They know they need to do this,” Granoff says. “They are not opposed to the transparency. I think they are worried about the challenge of getting the information to the patient.”
In the end, this is something that they will have to do:
There are no plans to revise the pricing requirement. The state’s undersecretary for the Office of Consumer Affairs, Barbara Anthony, says the time has come to put price tags on health care.
Here is the link to the full article: Mass. Launches A Grand Experiment: Pricing Health Care | CommonHealth
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