NCPA - National Center for Policy Analysis

Difficult Process of Comparing Health Care Costs

November 22, 2013

Finding out how much an X-ray costs sounds like a simple question, but it is actually very difficult to get an answer. In Massachusetts, a new state law requires insurers to be able to tell members how much a test, treatment or surgery will cost. But while the new law pulls back the curtain on prices of health procedures to some degree, the burden is still on the patient to ask for information, says Kaiser Health News.

  • The point of this new requirement is to help patients make smarter choices so that they start behaving more like consumers of health care.
  • Insurers aren't thinking that way.
  • They all sound a little overwhelmed by trying to put a price tag on medical care.

"Health care is very complex and so it's difficult to make things simple, straightforward and precise," says Derek Abruzzese, the vice president for strategy and product development at Tufts Health Plan.

Insurers are also worried about getting the price right because the new state law puts insurers on the hook if they are wrong. Sue Amsel is working on a shopping tool that insurer Harvard Pilgrim Health Care is developing.

  • If someone wants to compare X-ray prices, they have to fill out separate online forms for each X-ray lab.
  • Then the insurer has 48 hours give them an estimate.
  • It takes roughly 20 minutes to fill out a single form.

Harvard Pilgrim will spell out what's included and what's not in its estimate. So residents of Massachusetts can find out in advance, how much everything from a blood test to open heart surgery costs. But in these early days at least, it isn't quick or easy.

Source: Martha Bebinger, "How Much Is That X-Ray? Still Hard To Say, Even In Massachusetts," Kaiser Health News, November 9, 2013.


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