Summary: Our work on PriceCheck was featured in JAMA Internal Medicine on Nov. 17, in an article by one of our California partners, Lisa Aliferis of KQED, along with an editor’s note by the JAMA editor. The editor’s note called us “bold” and a supplier of “essential information,” and called for more of the same (signup for free access to current issue required).
“Without knowing either quality or price, it is impossible for marketplace principles to apply,” the JAMA (Journal of the American Medical Association) Internal Medicine editor, Rita Redberg, wrote in her editor’s note. “In her Viewpoint, Aliferis, a health care journalist, describes a bold attempt to change this situation in the San Francisco and Los Angeles metropolitan areas.
“PriceCheck is a new program that invites patients to share information about what they have paid for common medical tests and procedures. Because newer health insurance plans, including many of those offered on health insurance exchanges under the Affordable Care Act, often have substantial copays, such as percentage of the cost of a medical test, this information really matters to patients. PriceCheck has started to supply that essential information. Similar projects are already underway in other communities.
“I hope to continue to see these programs expand as part of an effort to provide essential information for patients and clinicians to make wise and informed choices in health care.”
Aliferis’s “Viewpoint” piece concluded:
“The window is cracked open on health cost transparency. We have been here before—with car sales, with airline tickets. Now, technology in combination with transparency can do the same for health care.
“And yes, we have been asked whether people should ‘shop’ for medical treatment in the same way they shop for a new car. If there were a correlation between cost and quality, this might be a reasonable question. Instead, in American health care, money is spent on unnecessary or unproven treatments much too often, and there’s widespread variation in price. People are waking up to these facts.
“The money conversation makes the practice of medicine very complicated: the ‘gotcha’ bill and the medication that is not covered challenge the physician-patient relationship. It is time to take off the blindfold and embrace transparency in pricing for medical care and services.”
In California, that MRI will cost you $255 — or maybe $6,221
NPR also featured us, in Aliferis’s article talking about the JAMA piece.
“Prices for common medical tests like mammograms and MRIs are notoriously opaque. Negotiated rates between insurance companies and doctors or hospitals are sealed tight by contract. We know there’s price variation, but comparing what one insurance company pays versus another is virtually impossible,” she wrote.
“That’s why we here at KQED in San Francisco turned to members of our audience to help us find out what medical tests and devices cost.”
The article on the NPR site collected hundreds and hundreds of comments.
One commenter wrote: “What we need is some way to increase buyer power in this kind of market. Some way to make it so that buyers are not negotiating from a weak position — not only one of fearing death but also with some monetary strength so they’ll actually be heard.”
Another wrote: “Universal Healthcare! Single payer publishes amount it is willing to reimburse for procedure. Provider publishes charge and patient is notified upfront difference between charge and reimbursement- out of pocket amount. Under universal healthcare, there are no ‘networks’ to negotiate. If unsatisfied with cost of provider, find one which is more reasonable. Double secret deals by for profit insurance providers are designed to line the pockets of the insurance company, not control healthcare cost. They have had their day and failed miserably. Time to move to the model that is working for the rest of the first world.”