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Hospital Ratings Systems Share Few Common Scores And May Generate Confusion Instead Of Clarity

Posted by on March 3, 2015

Summary: Quality measurement is a hot topic in health care these days. There are many systems, and they tend to disagree. Now seven experts have published a paper in the influential “Health Affairs” journal’s March 2015 issue, titled: “National Hospital Ratings Systems Share Few Common Scores And May Generate Confusion Instead Of Clarity.” Click here to read more from the abstract.



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Hello, Philadelphia! We’re here to inventory your health care prices.

Posted by on February 27, 2015


Summary: We’re excited to be rolling out WHYY’s PriceCheck project in Philadelphia, with our great partners at WHYY The Pulse in Philadelphia. We’re kicking off a six-month project to build a community-created guide to health care prices in the Delaware Valley with the WHYY The Pulse journalists, on the model of our California PriceCheck project.



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Minnesota’s nonprofit health care: Can you heal me now? | Star Tribune

Posted by on February 25, 2015

Summary: Nonprofit or for-profit? In the hospital world, as in the journalism world, there are a number of preconceptions about these two words, and the business practices that underlie them. So when the Minnesota Star-Tribune ran a commentary recently about that topic in connection with health companies, I was really interested. Read on for details, or ….



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In Australia, the same problems: Spotlight on specialists’ fees

Posted by on February 16, 2015

Summary: The health care cost problems that plague the United States are not unique. Australia’s system has some of the same issues, as Professor Lesley Russell writes: “The impact of specialist fees on government and patient budgets has received little reform attention. This is despite the government’s push for controls in health-care spending and growing evidence of the affordability problems faced by sick Australians.” Keep reading for more, or…



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Most common medical procedures: arthroscopy, CT scan

Posted by on February 1, 2015

Summary: What are the most common surgical procedures and imaging procedures? Well, it’s not exactly what you’d think. We like data, facts and figures, so when North Carolina posted price information recently, it wasn’t just the prices we were interested in.



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University of Florida College of Medicine features us

Posted by on January 28, 2015


Summary: The University of Florida College of Medicine has added us as a resource on their site: “To complete the following, UF Health patients must sign the healthcare cost authorization form in order to obtain a copy of their hospital charges. Contact Mary Delaplaine (265-0371) and give her the patient’s DOB or MR# so she can have the charges pulled and tell you when to pick them up. You will take the authorization form to Admissions on the first floor of the north tower and exchange that for the charges. The VA does not give out charges but you may use the following resources to estimate charges. or”


Our community loves us: Another testimonial

Posted by on January 27, 2015

Summary: It’s great to hear from people who have used our information. Here’s one: “When my local hospital charged me $1,000 for a routine ulstrasound, Clearhealthcosts helped me find out how much I was being overcharged. The database is by far the simplest and clearest way to compare real healthcare prices in New York state — it’s the only resource that gives you a simple dollar figure, rather than a dizzying array of codes and modifiers. When I wanted to dig deeper, the site’s explanation of how to navigate the Medicare price database was also invaluable. Armed with this data, I was able to convince my hospital to give me a discount, because I could prove that they charged me 40 percent more than Medicare patients for no discernible reason.” –J.R., New York.


North Carolina Blue Cross releases reimbursement rates. Will others follow suit?

Posted by on January 19, 2015


Summary: North Carolina Blue Cross took a startling step about a week ago: It released in consumer-friendly form a tool specifying what it pays to providers across the state for different common procedures under contractual agreements. Why is this important? Well, common practice in the health care market is for insurance companies to keep these contract prices or negotiated prices secret — presumably because Blue Cross doesn’t want Provider A to know it’s getting paid $543 for an MRI, while Provider B is getting paid $2,357.



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California Hospital Fair Pricing Act Reduced Prices Paid By Uninsured

Posted by on January 18, 2015

Summary: “Health Affairs abstract: California’s Hospital Fair Pricing Act, passed in 2006, aims to protect uninsured patients from paying hospital gross charges: the full, undiscounted prices based on each hospital’s chargemaster. In this study I examined how the law affects the net price actually paid by uninsured patients—a question critical for evaluating the law’s impact. I found that from 2004 to 2012 the net price actually paid by uninsured patients shrank from 6 percent higher than Medicare prices to 68 percent lower than Medicare prices; the adjusted collection ratio, essentially the amount the hospital actually collected for every dollar in gross price charged, for uninsured patients dropped from 32 percent to 11 percent; and although hospitals have been increasingly less able to generate revenues from uninsured patients, they have raised the proportion of services provided to them in relation to total services provided to all patients. The substantial protection provided to uninsured patients by the California Hospital Fair Pricing Act has important implications for federal and state policy makers seeking to achieve a similar goal. States or Congress could legislate criteria determining the eligibility for discounted charges, mandate a lower price ceiling, and regulate for-profit hospitals in regard to uninsured patients.” Ge Bai, “California’s Hospital Fair Pricing Act Reduced The Prices Actually Paid By Uninsured Patients”, Health Affairs, January 2015.


Narrow networks topic hits home | Reporting on Health

Posted by on January 17, 2015


Summary: When insurance companies and providers can’t come to agreement on payments, networks become narrower. The results? People have to make different choices — either keep their insurance policy, or keep their doctors, or some other choice. Here’s one California woman’s story of how her saga is playing out — with the twist that she’s Martha Shirk, program consultant to the California Endowment Health Journalism Fellowship and a senior fellow there, after 23 years as a reporter at The St. Louis Post-Dispatch. Also, both the insurer and the provider are nonprofits, and both accuse the other of being, well, moneygrubbers. Click to read more, or ….



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