Culture Change Is Here: People Are Price-Shopping for Health Care

Summary: Culture change is here. People are upset about rising health care prices and rising out-of-pocket expenses. In fact, they’re so upset that they’re acting like consumers, by shopping around for their health care, and by sharing information, and by complaining about their outrage. And that’s a good thing. 

When I founded clearhealthcosts.com a few years ago, I announced: “We’re bringing transparency to the health care marketplace by telling people what stuff costs.”

People laughed at us. They said it was impossible. We heard every objection you can imagine. And now: price transparency is a primary topic at conferences, in board rooms, on Twitter and Facebook, on the front page of The New York Times.

Make no mistake about it: Culture change is here. Here are some of the reasons we know that to be true.

People told us that no one would ever shop for health care because it’s too important: if it’s your life at stake, or the life of a loved one, money is no object.

Listen for a bit, then, to my friend Peggy Zuckerman, a cancer survivor, as she wrote in a blog post about learning that a  CT scan she needed for a checkup could cost $276 or $8,010, or my friend e-Patient Dave DeBronkart, also a cancer survivor, as he wrote on his blog about issuing an RFP for treatment of his skin cancer.

People told us that once the Affordable Care Act came into effect, everyone would be insured, and that meant that everything would cost $20 – or whatever your co-insurance or co-pay is. So prices would be irrelevant.

Listen, then, to my friend Justin Evans, who I wrote about in this blog post because he has pretty good insurance — and he walked away from an emergency gall-bladder operation with a combined co-insurance and deductible bill of $6,104.64.

People told us that everybody in the health care marketplace hates the idea of transparency, because they’re all making money on the lack of transparency.

Listen, then, to my friends Dr. Kenneth Croen, a Scarsdale, N.Y. , doctor, and Dr. David Belk, an Alameda, Calif., doctor – both warriors for transparency.

People told us that nobody wanted to talk about shopping for health care. Listen, then, to these women who contributed to our crowdsourcing pilot project with WNYC public radio in New York, and who appeared in our series of blog posts about that effort.

“This is such a great idea….We have huge ‘out of pocket’ expenses that are calculated in a ridiculous way that always seems to benefit the insurer.”

“This is an excellent topic for discussion. Too many health care costs are unclear to consumers and we have to all learn to ask questions about services, cost, and view some types of health care purchases as we do other types of expenses.”

“I asked what it would cost…. The answer — $180 if I could pay it all that day, $540 if I wanted a payment plan.”

“I am outraged and I’m fighting the bill.”

“ I have a very high deductible policy. I always say I don’t have insurance as I never meet the deductible. … I pay $100 for the mammogram and a similar amount for the radiologist…IF WE ALL CARED ABOUT THE ACTUAL FEE FOR MEDICAL SERVICE WE RECEIVE AND HELD INSURANCE COMPANIES ACCOUNTABLE, PREMIUMS WOULD HAVE TO DROP.”

Policy experts agree: Transparency, now.

So: Culture change is here. Transparency is here, it’s vitally important, and it’s the biggest trend in health care.

What we’re doing to help at clearhealthcosts.com:

Our surveys of cash or self-pay prices for common procedures; they can be found on our home page at clearhealthcosts.com. We’re surveying providers on 30-35 common procedures in seven U.S. metropolitan areas. The prices can vary by as much as 10 times: An MRI for $350 or $3,500? Find it here!

Our new hospitals database: we have collected cash prices for big-ticket items. We’re just rolling this out now, in a very basic form. We have about 6,500 prices from almost 160 hospital and surgical-center providers in 20-some states. For now, find it at this link. We’re adding data all the time.

Coming soon: We’re excited about our new crowdsourcing project, funded by the John S. and James L. Knight Foundation, in which we’ll collect price information with our partners, KQED public radio in San Francisco and KPCC-SCPR, Southern California Public Radio in Los Angeles.  We’ll be live soon with this project, a bigger, better version of a pilot we did recently with WNYC public radio.

Transparency is here. It’s a growing movement, and you probably want to know how you can help.

You’ll be in good company – there are a lot of us in this growing ecosystem, including companies, individuals, academics, government officials, regulators and many more. We’re happy to join hands with like-minded people.

Ask: “how much will that cost?” and share the options you find. Even if you’re insured, even if the provider says “we don’t know” and the payer says “it’s the provider’s fault.” Point out disparities. If they say they can’t tell you what it costs, ask again. And again.

Join the ranks of transparency warriors. Culture change is here.

See more at DisruptiveWomen.net.