Summary: We collect and display cash or self-pay prices — what you would pay without insurance — for about 30-35 common, “shoppable” procedures. Why? To show the range of pricing for simple medical items, which can more or less be compared — as apples to apples. If you see that an MRI can cost $300 one place and $6,000 another place, you’ll be better informed about the health care system, and better able to make money decisions relating to health care.
Summary: When people travel from their own country or their own city to another for care, it’s called medical tourism. How much is there? Depends on who you talk to, and how you define it. “Mexico is already the world’s second-biggest medical tourism destination (behind Thailand), generating $3 billion in 2014. Mexican agencies expect that with increased investment, the country could grow medical tourism revenues to $10 billion-$12 billion in the next seven to eight years. Oil-rich countries in the Middle East, notably the UAE and Saudi Arabia, view better health care provision – including medical tourism – as a way to diversify their economies,” according to a 2016 Deloitte study. Some U.S. destinations, including Las Vegas, have sought to develop a medical tourism industry. Here’s a look at Central Florida’s attempt to become a destination. Here’s a slightly dated roundup on international medical providers. Also, a number of big-name hospitals — M.D. Anderson and Memorial Sloan-Kettering, for example — actively pursue patients from overseas, but real figures are hard to find.
Gavin St. Ours/Flickr/Creative Commons Attribution License
Summary: Why would health care providers want to publicize prices? Of course, you could also ask why they wouldn’t — why we have made a system that keeps patients in the dark about prices until that dreaded bill comes. When we were featured in a Wall Street Journal article by Melinda Beck about providers accepting cash payments that are lower than their chargemaster (or sticker) prices, the comment stream featured a thoughtful reader named Bill Willis. Willis and I struck up a conversation. He is a retired health care consultant and a former hospital executive with a perspective on the marketplace that we don’t often hear. So I asked him to write about the topic. We have seen a lot of providers starting to list prices, but it’s still the exception, not the rule. Willis starts by saying “It may be difficult in some cases, impossible in some, but doable in others to convince providers to disclose their pricing.”
Summary: A shift in the way hospitals collect bills has been taking place for some time, and is picking up speed. “Hospitals and providers, historically, received 90% of the reimbursement from insurers, according to The Advisory Board. The patient portion was more of an afterthought,” writes Holly Fletcher at The Tennessean. “That dynamic is shifting as more people come under high deductible health plans. The ratio could settle around 70-30 — with patients paying nearly a third of their bills, said Ken Kubisty, senior vice president at Advisory Board Consulting and Management. For every patient dollar being billed, hospitals have historically failed to collect 65 cents.” Almost a quarter of Americans have a deductible of $2,000, meaning that they pay out of pocket until that $2,000 level. So: What we’re seeing is that hospitals and other providers, in reaction to these trends, are establishing and accepting cash rates that may be lower than their negotiated or reimbursed rates, and yet allow them to get some money — even if not all of what they want. The landscape is changing daily, as hospitals and other providers look at their bottom lines, and try to figure out what’s next. For patients: Always ask “How much will that cost? How much will that cost me? How much will it cost if I pay cash?” Read Fletcher’s entire piece here.
Summary: “If you’ve had a mammogram or plan to get one, you may not have given much thought to where you should go. We hope to help you understand your choices by beginning a conversation about how to measure quality in mammography,” Martha Bebinger writes at CommonHealth at WBUR public radio in Boston. “Our data collection is not the definitive answer. But many women are surprised by the fact that where you get a mammogram can make a difference in your health. “I was never told anything about that. I don’t think it’s out there,” says Kennedy, who’s come to the Beth Israel Deaconess Medical Center clinic in Lexington for a routine screening mammogram. We collected information on five quality measures from a dozen hospitals that were willing to discuss how they perform when it comes to mammography. In addition to the table above, we have a detailed explanation of the project and the quality measures, as well as what each hospital is paid by one insurer for the test.” Martha Bebinger, Eva Gets A Mammogram: A Primer On Finding Quality In Mammography, CommonHealth, WBUR public radio.
Summary: “If you want to get an idea of the gap between the world’s sickest and healthiest people, don’t fly to a faraway land,” Alvin Powell, writes in The Harvard Gazette. “Just look around the United States. Health inequality is part of American life, so deeply entangled with other social problems — disparities in income, education, housing, race, gender, and even geography — that analysts have trouble saying which factors are cause and which are effect. The confusing result, they say, is a massive chicken-and-egg puzzle, its solution reaching beyond just health care. Because of that, everyday realities often determine whether people live in health or infirmity, to a ripe old age or early death. ‘There are huge inequalities in this country that often get overlooked … If you want to observe the problems of poverty and inequality, you don’t need to travel all the way to Malawi. You can go to a rural house in America,’ said Ichiro Kawachi, John L. Loeb and Frances Lehman Loeb Professor of Social Epidemiology and chair of the Harvard T.H. Chan School of Public Health’s Department of Social and Behavioral Sciences. ‘If you’re born a black man in, let’s say, New Orleans Parish, your average life expectancy is worse than the male average of countries that are much poorer than America.’” Alvin Powell, The costs of inequality: Money = quality health care = longer life” The Harvard Gazette.
Summary: A Pittsburgh hospital has rolled out a price transparency tool. It’s interesting not just because it is an official hospital estimate of cash or self-pay pricing, but also because the hospital offers a “point of service” discount — and also because their partner in creating this tool is Experian Health, a wing of the credit and financial services giant Experian.
Summary: We did an early crowdsourcing project asking women to share the price of their birth control pills, called the “PriceOfBC” map. We loved it so much we left it up on the site so people could see it, and see our progress in crowdsourcing, from this project through our WNYC pilot and on to the partnerships with public radio stations in San Francisco, Los Angeles, Philadelphia and elsewhere, as well as my work on the “How-To Guide to Crowdsourcing” at the Tow Center for Digital Journalism at Columbia University in New York, under funding from the John S. and James L. Knight Foundation. Here’s a link to the map.
Summary: “A type of pain that hospitals thought they had relieved has come back with a vengeance: it’s called bad debt. Hospitals have long struggled to collect bills when patients aren’t covered by insurance — creating delinquent accounts,” John Lauerman writes over at Bloomberg Business. “The Affordable Care Act was supposed to relieve some of that strain by helping pay for coverage for millions of Americans and expanding Medicaid in some states to cover the poor. Yet while millions of people have gained coverage since Obamacare became law in 2010, there’s also been an increase in insurance that comes with high deductibles and cost-sharing. Under those plans, the first few thousand dollars of annual medical expenses come out of patients’ wallets. That’s money that hospitals like Childress Regional Medical Center in the Texas Panhandle region are unlikely to collect. ‘It feels like a sucker punch,’ said John Henderson, the nonprofit hospital’s chief executive. ‘When someone has a really high deductible, effectively they’re still uninsured, and most people in Childress don’t have $5,000 lying around to pay their bills.’ The rate of uninsurance in the U.S. has fallen to 9.1 percent from 15.7 percent in 2009. Yet in the first nine months of 2015, about 36 percent of the U.S. insured were covered by high-deductible or consumer-directed health plans that can require considerable out-of-pocket payments, compared with about 25 percent in 2010, according to a CDC survey.” John Lauerman, “Bad Debt Is the Pain Hospitals Can’t Heal as Patients Don’t Pay,” Bloomberg Business.
Summary: “A top Texas health official is stepping down after co-authoring a study that drew strong backlash from Republican leaders for suggesting that cuts to Planned Parenthood are restricting access to women’s health care statewide,” Paul J. Weber writes for The Associated Press. “Rick Allgeyer, director of research at the Texas Health and Human Services Commission, was facing possible discipline for the study published this month in the New England Journal of Medicine. [Editors note: The original study is here.] He was eligible for retirement and will leave in March, agency spokesman Bryan Black said Thursday. Black said that Allgeyer — who has worked in Texas government for more than 20 years — broke policy by working on the study on taxpayer time. Other co-authors included one of Allgeyer’s subordinates at the health commission, University of Texas researchers and an Austin attorney who represented Planned Parenthood in lawsuits over being excluded from the program the study examined. ‘He should have never been putting in time on this study during the normal business day, he was paid to perform state business,’ Black said in an email. Published in one of the nation’s most prominent medical journals, the study found that fewer women in Texas have obtained long-acting birth control, such as intrauterine devices, after the GOP-controlled Legislature barred the nation’s largest abortion provider from a state women’s health program in 2013. Births paid for under Medicaid also increased among some women.” Paul J. Weber, Texas health official out after study on Planned Parenthood<,/a> The Associated Press.