More Data, But Health Care Still Hard To Figure
By Amy Jeter, The Virginian-Pilot |
It was a dream come true for anyone who loves spreadsheets, and the resulting analyses raised questions about how health pricing is determined in the U.S. system.
Still, it didn't tell you much about whether
Few people shop around for inpatient care anyway.
That's why it was a little more exciting when
On the one hand, it told me that
"This probably would be of most use, at least initially, to folks who are going to kind of slice and dice and analyze the data, and then come out with information that might be somewhat more consumer-friendly," she said.
Luckily, there already are more consumer-friendly places to go.
Check out
It tells you how often a facility performed that procedure -- more is typically considered better -- and provides its median charge, along with the statewide median charges by type of facility. (Hospitals usually, but not always, charge more than physician offices and ambulatory surgical centers.)
Did I say "charge"? Yes, I did.
Average reimbursements received by each hospital aren't available, said VHI Executive Director
There's more.
With a tool called "Health Care Prices," VHI publishes an "average allowed amount" for that knee surgery and other procedures. The allowed amount is the maximum that an insurance plan will pay for a covered service.
The VHI tool doesn't drill down to individual hospitals, but it does give an idea of what facilities statewide actually are accepting from insurers as reimbursement.
For the arthroscopic knee surgery, the statewide median hospital charge in 2011 was
Knowing those numbers can prove useful. Just ask Dr.
He's the CEO of a website called Healthcare Blue Book. The site gathers information from payers, providers and employers. It uses allowed amounts to determine what the blue book calls a "fair price."
For a knee arthroscopy in
An insured patient who knows this can shop around for a provider in the plan's network. An uninsured patient can use that number -- rather than the charge -- when negotiating a price.
"The A1 message to patients is to ask about cost of care before you get your treatment," Rice said. "Because after you've gotten it, it's too late."
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