PriceCheck: Not All Health Care Transparency Tools Are Alike

Aug 31, 2016

  Transparency is the new buzzword in health care with consumer demand fueling changes to state laws and giving birth to websites that publish prices for medical procedures.

WUSF partnered with WLRN in Miami to launch their own database called PriceCheck. But we're not the only game in town.

A Google search for the term “medical prices” turns up several tools you can use to look up healthcare costs.

If you have insurance, you may have seen a similar tool on your provider's website. Florida lawmakers even passed a price transparency law this year that will create a database of prices for medical procedures.

But how do you know what the price comparison tools are really telling you?

Let's sort some of it out.

On one side are for-profit sites that contract with health care providers. The sites list cash prices of common procedures that consumers can pay for up-front.

MDSave is one of the more popular sites, serving 140 markets around the country. CEO Paul Ketchel says the company negotiates with doctors, hospitals and other providers so consumers get just one price.

“That’s really what makes the product innovative because the consumer sees that real, full healthcare price for really the first time,” Ketchel said.

The company makes its money by charging doctors and hospitals a fee. It also gets a cut of what every consumer pays.

Though Ketchel says most people who use MDSave have insurance, some health care providers contract with the company so uninsured patients can pay their bills.

Viki Magurean  is Chief Financial Officer at 7 Rivers Regional Medical Center in Crystal River. She says the bundled cash prices are sometimes cheaper than those paid by people with insurance.

“Every insurance negotiates pricing on behalf on their covered members and MDSave is like an insurance who has negotiated pricing based on the uninsured,” Magurean said.

Not all health care price databases are in it to make a buck.

There are sites like ours. PriceCheck provides a space for consumers to enter prices they pay for procedures at specific facilities. You can also search prices that others have paid. We report on the data to spark conversations about the real cost of health care.

And while PriceCheck relies on consumers for information, other sites use records. The not-for-profit FAIR Health group has compiled more than 20 billion records of medical and dental services from insurance companies, health plans and health care systems.

FAIR Health was launched in 2009. It doesn't provide details about specific doctors or hospitals, but you can get a good estimate about what people in your area are paying for a procedure.

“Our data have in effect helped steer people through the rocks as they try to navigate these class five rapids of reform,” said FAIR Health president Robin Gelburd.

She says consumers, insurance companies and health care providers all use FairHealth. Florida policymakers building the state's database also have talked to her group.

She says anyone involved in price transparency owes it to consumers to make sure the information they provide is helpful.

Suzanne Delbanco is executive director of the healthcare watchdog group Catalyst For Payment Reform.

She knows consumers are thinking first about the price tag. But that may not be the best strategy.

“You want to take the quality into consideration too,” Delbanco said.

She says the best health care comparison tools offer a way to measure quality as well as price.

“Pair it with quality information so that I'm not being misled by the price alone, which really at the end of the day is not a good proxy for the overall value of the care I'm going to get,” Delbanco said.

Five years ago, she says, consumer advocates dreamed of having more price transparency tools. Now, the information is there, now we just have to sort it out.

To see the costs of medical procedures in your area and enter the prices you pay, visit HealthNewsFlorida.org and click on PriceCheck.

Julio Ochoa reports for WUSF in Tampa. WUSF is part of Health News Florida, which receives support from the Corporation for Public Broadcasting.