How much does stuff cost: More transparency of the limited sort

codeview

Everybody wants to be transparent these days.

A new pricing tool came across my radar today, this one from AthenaHealth, the  medical services company  that has expanded into electronic medical records, doctor practice management, patient communications and so on.

One of their biggest services has to do with practice management, and that, of course, includes on of our favorite topics, billing.

An AthenaHealth tech guy just wrote a blog piece rolling out a tool called “CodeView,” which lets us peek at some of Athena’s pricing information, that info that is usually kept under lock and key. This new tool shows average prices, along with Medicare and

Medicaid reimbursement rates, for a few key procedures and items. The data’s national; if you give up some personal information, you can see regional info (I didn’t).

“Actual commercial contracted rates are some of the best kept secrets in health care, and while we guard individual provider data with our lives, our massive database allows us to compare and benchmark contracted rates across 40,000 providers, in all 50 states,” writes the analytics chief at Athena, Iyue Sung. “We can access medical billing rates for commercial payers, Medicare and Medicaid, and have done so: the result can be explored in a new app we’ve developed called CodeView.

“CodeView displays the maximum, minimum and average dollar amounts that insurers pay providers. Why does this matter? Because having access to accurate price information is essential to decrease cost. Furthermore, as any free marketer knows, having visibility to the differences in prices is key (we won’t get into the issue of private vs. single-payer systems). Those differences, the gaps, are what CodeView really attempts to highlight.”

The most interesting thing in the blog post: “It is generally understood that commercial payers have a much wider variation in contracted medical billing rates than Medicare for a given procedure. What surprised us a bit with this data is that some providers are actually paid less by commercial insurers than by Medicare, for the same procedures.”

We appreciate and applaud all transparency plays — including healthcarebluebook.com, fairhealthconsumer.org (both services with large amounts of data that have a small consumer-facing tool and a big practice selling more detailed information to businesses) and CastLightHealth (available only through your employer).

Those three, and others, keep the really important information — how much will I pay to this particular provider? — in the dark.  So they’re a kind of transparency, but really more on the order of transparency for a few.

So for whom is CodeView useful? A consumer/patient wanting to price  a procedure or item? Or a physician practice, wanting to know what are the limits of pricing? Hint: “Select your specialty” is the prompt.

And so, CodeView. Also transparency, of a sort. For a few.