By Salynn Boyles, Contributing Writer, MedPage Today
Published: June 19, 2013
Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco
Action Points
A growing number of state-run websites are designed to help consumers compare the cost of healthcare services, but most lack critical pricing information and aren't all that useful, a study found.
The study authors suggest that by focusing information on services that are predictable, non-urgent, and subject to deductibles (e.g., routine outpatient care for chronic diseases), greater relevance to patients could be provided.
A growing number of state-run websites are designed to help consumers compare the cost of healthcare services, but most lack critical pricing information and aren't all that useful, a study found.
Most of the 62 state-sponsored websites studied focused on in-hospital services rather than routine, non-urgent outpatient care, and most reported "billed" charges instead of the negotiated fees patients usually end up paying, according to the study, which was published in the June 19 issue of the Journal of the American Medical Association.
Although pricing transparency has improved greatly over the past few years, patients are still not getting the information they need to make informed decisions about healthcare spending, said lead author Jeffrey Kullgren, MD, MPH, of the Ann Arbor (Mich.) VA Health Care System and the University of Michigan Medical School.
"Ours is really the first empirical effort to examine what is being reported and identify specific areas that can be improved upon, and we did find clear opportunities to make these sites more relevant to consumers," Kullgren told MedPage Today.
With almost one in three privately insured adults now enrolled in high-deductible plans, providing usable pricing information to help consumers anticipate their out-of-pocket costs and understand their options is critical, he said.
Between January and May of 2012, the University of Michigan and Ann Arbor VA researchers conducted systematic Internet searches to identify publicly available state-run websites designed to do just that.
They excluded websites run by specific health plans, because those sites are usually intended for enrollees only. Websites run by third parties were also excluded from the analysis.
As of early 2012, the researchers identified 62 websites run by state government agencies or hospital associations. About half (46.8%) had been launched since 2006.
The analysis revealed that:
Most of the websites reported prices for inpatient care involving specific medical conditions (72.6%) or surgeries (71%).
Far fewer sites reported pricing information for more routine outpatient services, such as diagnostic or screening procedures (37.1%), radiology studies (22.6%), prescription drugs (14.5%), or lab tests (9.7%).
Most websites included only the billed charges (80.6%). For services that included facility and professional fees, most price estimates (66%) included only the facility fee.
Fewer than one in 10 (9.7%) price estimates incorporated patient insurance status or specific health plan information (8.1%). And for nonstandardized services -- outpatient surgery, for example -- quality information was rare (13.2%).
"Greater relevance to patients could be realized by focusing information on services that are predictable, non-urgent, and subject to deductibles (e.g., routine outpatient care for chronic diseases) rather than services that are unpredictable, emergent, or would exceed most deductibles (e.g., hospitalizations for life-threatening conditions)," the researchers wrote.
Likewise, basing cost estimates on negotiated payments and not the bills patients see would provide more useful information to consumers, but only a few state-run websites are doing this, Kullgren said.
"We often hear that negotiated rates are proprietary information, but an increasing number of states have passed laws that allow them to collect and report those data so this is not as big of an issue as it once was," he added.
He cited New Hampshire's 'HealthCost' site as a consumer-friendly website that succeeds in giving patients useful information about healthcare costs.
Patients who provide their ZIP code, insurance provider, deductible, and coinsurance can obtain estimates of what they would be expected to pay and what their insurer would pay for a medical procedure or service at facilities in their area, based on negotiated rates.
One other challenge is reporting the entire cost of a procedure, such as a colonoscopy, when there are facility fees and multiple specialists involved, Kullgren said.
"Ideally, if the goal is to inform patient decisions, we need to pull together a price that reflects the full episode of care as opposed to piecemeal reporting," he said.
- Posted using BlogPress from my iPad
Location:Georgetown,Tx United States
No comments:
Post a Comment