For years, the soaring cost of health care has pummeled household, government, and corporate budgets alike, and experts have said one of the single biggest problems: Consumers can’t go price-shopping for medical procedures like they can for a car or television set, so there’s been little visible price competition for consumers to lower costs.
But starting Oct. 1, that has changed in a big way in Massachusetts, and the new law can save Bay State consumers big money. As of that date, all 13 health insurers operating in the state have had to make available online tools showing the net out-of-pocket cost to consumers -– based on their individual health plan’s deductibles and co-payments and their year-to-date spending – of procedures like MRIs, X-rays, colonoscopies, and common surgeries.
You can find your health insurer’s cost-comparison tool through the website www.GetTheDealOnCare.org
One day recently, Sue Amsel of Harvard Pilgrim Health Care took me through their “Now I Know’’ tool -– rival companies have similar services –- and showed me how based on where I want to go, an MRI knee scan could cost me as a Harvard Pilgrim subscriber anywhere from $343 to $1,700, depending on whether I wanted to go to a low-cost MRI provider in Brookline, Mass., or a prestigious Harvard-affiliated teaching hospital downtown.
The same day, thyroid gland tests were running anywhere from $23 to $95, echocardiograms $305 to $549, and colonoscopies $945 to $1,700.
Amsel cautions that in some cases, the tool won’t necessarily tell you your exact final cost. “What's not included is typically things like anesthesia, because we don't know what the person's going to have, and any additional tests over and above the standard’’ that the health plan pays for.
But what she also makes clear: There’s little to no correlation between how much you pay and how highly ranked the doctor is. Harvard Pilgrim will identify “honor roll” physicians ranked in the top 25 percent for patient satisfaction and readmissions and complications and other factors, and pulling up the ten top-ranked colonoscopy providers –- both the least expensive and the most expensive were on that list. And the same doctor could charge you a widely differing price depending on which of three hospitals she or he is affiliated with you choose to have the procedure performed at.
It’s one thing to now, theoretically, that the net prices we pay for medical procedures are often completely arbitrary. But now in Massachusetts, consumers can see just how arbitrary they are, and policymakers hope over time, as they gravitate towards high-quality low-cost providers who come up on their shopping tools, that can finally begin to break the relentless upward spike of health-care costs.
With video editor Lauren Kleciak and videographer Marc Jackson