Patients want to shop for care, but have a hard time finding good tools: NPR

Filed Under: Costs, Health plans, Patients

Summary: “Kate and Scott Savett were trying to be responsible when they needed some medical care… Scott, 43, is a chemist and designs software for labs; Kate, 37, works in life insurance,” wrote Elana Gordon, at our partner WHYY public radio in Philadelphia, a bit ago. “They buy their health insurance through Scott’s job, and to keep their premiums affordable, they chose a high-deductible plan. They understood from the beginning that this would mean shopping carefully when they needed care…. For years the couple didn’t use their insurance much — but that all changed this year. Kate was diagnosed with multiple sclerosis in January. Doctors did a lot of tests and then follow-up tests. On top of that, Scott needed some imaging tests for a spinal issue. Under their insurance plan, the two have to pay in full for the first $3,000 of their combined care. After that, they still have to pay 20 percent of the cost, until they reach a total of $8,000 in out-of-pocket expenses. That experience made them want to find the best care for the best deal. But how? They investigated, using an online cost estimator offered through their insurance company. Scott logs in to use the tool, and searches for the typical cost of MRI scans in his region. The online calculator tells him the average cost is $1,270; the lowest is $512 and the “above average” is $1,790. The tool then produced a list of different providers and an estimate of how much they will specifically charge under the plan the Savetts have. At first, this kind of information seemed great to the couple. But it quickly proved to be quite the headache. A few days before Kate was scheduled to have her first MRI, she and Scott got a call from the radiology office, saying that the scan would cost them $2,400. They were shocked — the online calculator had told them it would only be about $500.” Elana Gordon, “Patients Want To Price-Shop For Care, But Online Tools Unreliable,” NPR Shots.