health care consumers

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Colonoscopies, Mammograms And Childbirth Are Americans’ Most-Shopped Health Services

The idea of comparing prices and quality when we are in the market for health care is pretty new territory in our country of avid shoppers. But more and more employers and insurers are giving patients tools that let them put in the name of a test or procedure and see who charges what.

So what are patients shopping for? A study out Monday looked at the health care shopping habits of 332,255 members of insurer Aetna in 2011 and 2012. The top shopped service was a colonoscopy. Coming in at second and third, respectively: a mammogram and childbirth services.

Patient shoppers were typically younger, healthier women who had a high-deductible plan and had time to plan ahead. But overall, only about 3 percent of those who had access to Aetna’s “Member Payment Estimator” used the tool — even though surveys show patients want prices.

“This suggests that our efforts to engage patients with price information are still very much a work in progress,” one of the study’s co-authors, Anna Sinaiko, said in an interview. She’s a research scientist in the Department of Health Policy at Harvard’s T.H. Chan School of Public Health.

Sinaiko said patients often do not know where to find a price at the time they are making an appointment or choosing a hospital.

“This question of how to get this information to patients is the key one going forward, and continuing to fill this gap is the important work that lies ahead,” Sinaiko said.

Most health care comparison tools offer limited quality information because few reputable organizations have determined how to measure quality and collect the numbers.

We have some quality data that we’ve previously collected and published on colonoscopies, mammograms and childbirth. At the very least, we hope this will help you ask more informed questions if you are trying to figure out where to find the best value for your health care dollar.

The study appears in the April issue of the journal Health Affairs.

Our Past Quality Measures Reporting:

Harvard Health Care Blog Debut: How To Use Hospital Rankings


Click on your bookmarks tab, please, everyone. Announcing a new blog that looks very worth following: An Ounce of Evidence, featuring Dr. Ashish Jha, The C. Boyden Gray Associate Professor of Health Policy and Management at the Harvard School of Public Health.

In his first package, Dr. Jha not only analyzes the recent harvest of hospital rankings from U.S. News and World Report, Consumer Reports and The Leapfrog Group. He also offers guest posts from some of the the rankers themselves, discussing what they do and why.

Dr. Ashish Jha (HSPH)

As health policy goes, the blog is shockingly readable (yes, that’s a left-handed compliment if ever there was one) and uses car-shopping as a helpful analogy. For example:

If you’re lucky enough to find a hospital that gets rated highly by all three organizations, I’d take that in a heartbeat. It’s like finding a car that drives well, looks stylish, is reliable, and safe! No brainer. Unfortunately, those hospitals are rare. In Boston, Massachusetts General Hospital was ranked the #1 hospital in the country by U.S. News. It got an “A” from Leapfrog. It was near the bottom of Massachusetts hospitals in the CR rating, receiving a score of just 45 out of 100.

It can be easy to decide if the safety, or the style, or the performance of a car is most important to you. Unfortunately, choosing what’s most important in health care can make us ask difficult and seemingly unreasonable questions. Is my primary goal to survive my hospitalization, avoid infections and medication errors, or have a reasonably good experience? Every individual has to decide what matters most. If a low mortality rate is most important, U.S. News is your best bet. If you care most about patient safety, then Leapfrog is the way to go. Consumer Reports emphasizes infections, unnecessary radiation and patient experience. If those matter most, CR is your best bet.

My personal list ranks mortality as most important (by far), followed by safety, with patient experience an important but distant third. Others will make different choices.

So why, I asked, is Dr. Jha, a prominent researcher and practicing physician, adding a blog to his very full plate? He explained: Continue reading