New website helps patients comparison shop for health care
Risa Lavizzo-Mourey needed cataract surgery in late 2014 and wanted to know how much the routine procedure would cost. Her doctor and his billing office didn’t know, and she never got the answer.
“Could there be a clearer example of the lack of transparency in the US health care systems?” she asked in her blog.
Lavizzo-Mourey wasn’t just anyone wondering what a good price would be for her medical procedure. She’s chief executive of the Robert Wood Johnson Foundation, which bills itself as the nation’s largest philanthropy dedicated solely to health — and transparency in medical pricing.
Lavizzo-Mourey’s frustration is shared by millions of consumers who are trying to shop for lower prices for medical tests, procedures, doctor visits, surgeries, and hospital services. But that is changing with the emergence of websites where consumers can see a range of prices and providers for medical procedures and tests.
Saveonmedical.com, an advertising-supported website and the only one currently operating in Massachusetts, offers limited comparison shopping for common procedures and tests because the only prices shown are from providers who bought ads on the site.
Other providers are listed with no prices, but the site offers to get a quote for you.
At Saveonmedical.com, customers prepay in cash and schedule appointments through the website. The company is testing technology to process insurance claims. Prepaying appeals to those with high deductibles like John Wakefield of Tampa, Fla., who had an MRI on his spine last fall.
“It was pretty simple and straightforward,’’ he said. “I paid Saveonmedical and scheduled the service through them. I have catastrophic insurance with a $6,500 deductible.”
He paid $450 for the test, or between $500 and $600 less than what the local hospital would have charged.
If you live north of Boston, Saveonmedical.com lists a knee MRI for $550 at InMed Diagnostic Services in Stoneham, versus a “typical” price of $1,736, which the site arrives at by aggregating data from Medicare, insurance claims, other sites, and from calling around.
With out-of-pocket costs rising from an average of $401 in 2010 to $1,318 in 2015 for those with employer-provided health insurance, according to the Henry J. Kaiser Family Foundation, shopping around has become imperative for many.
“Bringing pricing out of the shadows will force providers to explain why a $6,200 MRI is better than a $400 one,” said Jeanne Pinder, chief executive and founder of the health care shopping site Clearhealthcosts.com in New York.
Health care expenditures per capita in Massachusetts are among the fastest growing in the nation, having increased 4.8 percent from 2013 to 2014, according to a report released last fall by the state-run Center for Health Information and Analysis.
Despite a groundbreaking 2012 law that mandates price transparency, getting information remains a challenge, according to a report, “Mass. Hospitals Weak on Price Transparency,” conducted by the Pioneer Institute, a public policy research organization in Boston.
Researchers struggled to obtain prices from 22 Massachusetts hospitals for a common knee MRI. When they were able to get the information, the cost ranged between $700 at a community hospital to more than $8,000 at a Boston hospital.
“The process was time consuming, confusing, and replete with long rounds of telephone tag. Most Massachusetts hospitals don’t seem to embrace a culture of price transparency,” a Pioneer senior fellow, Barbara Anthony, said in the report.
Despite the difficulty of researching prices, a 2015 study by New York-based Public Agenda, which focuses on complex public interest topics, found that 56 percent of Americans have researched prices prior to getting care, and 21 percent have comparison-shopped.
“There is an unstoppable movement for more health care price transparency, but we should not be fooled that we are far along that path,” said Consumer Reports’ associate director of health policy, Lynn Quincy. “Just because there’s been private development doesn’t yet mean consumers are changing how they are consuming health care.”
Saveonmedical.com’s limited presence could soon expand in Massachusetts if a proposed deal with a large medical imaging provider is reached, chief executive and cofounder Matt Schneider said. The four-person company is currently focused on nine states, including California and New York.
In seven cities, but not in Boston, Clearhealthcosts.com takes a different approach, according to Pinder, who spent 23 years as an editor and reporter at The New York Times.
The company gets pricing information from surveys, research, Medicare, and crowdsourcing, which asks consumers to share their health care procurement experiences.
Clearhealthcosts.com — not to be confused with Clearcosthealth.com, an unrelated health care shopping site — has a prominent “Share your prices” button that lets consumers join in the crowdsourcing and compare notes.
Clearhealthcosts.com makes money by providing partners with its pricing tools for inclusion on their websites. The focus of those partnerships has been with public broadcasting outlets such as KQED in San Francisco, KPCC public radio in Los Angeles, and WHYY public radio in Philadelphia. Similar deals are in the works in Florida, she said.
Massachusetts health care insurers also provide cost and quality tools. For instance, Harvard Pilgrim Health Care Inc.’s “Now iKnow” offers members information on health care and quality.
While the Massachusetts Hospital Association offered a statement supporting pricing transparency, it warned that health care pricing and insurance are complex.
“Ensuring that the prices on such websites are accurate for individual patients can be an extremely complex undertaking,” said senior director of managed care Karen Granoff.
Correction: Due to a reporting error, the name of the senior director of managed care for the Massachusetts Hospital Association was incorrect in an earlier version of this story. She is Karen Granoff.