What Every Patient Should Know About Shopping For Health Care

When I recently decided to shop around for a pelvic ultrasound ordered by my doctor, I discovered something sobering:

We comparison-shop for cereal, so why not for health care?

Within a 7-mile radius in greater Boston, the pricetag for the very same diagnostic test varied widely, from $500 to $2,500. “Eye-opening,” was the way Robert Seifert, a principal associate at the Center for Health Law and Economics at the University of Massachusetts Medical School, described it.

My family, like most in Massachusetts, has health insurance that covers this type of test, so normally I wouldn’t have cared too much about the cost. But I was motivated to find out because a colleague, WBUR’s Martha Bebinger just launched a new social networking site, Healthcare Savvy, that allows patients to compare prices, share ideas on bringing down the cost of health care and generally vent.

So, inspired by this new community, I set out to do something radical: comparison shop for health care. Here’s what I learned:

At the prestigious downtown Boston teaching hospital, Massachusetts General, I was quoted a price of $2,563 for my ultrasound. At the well-respected community hospital, Mount Auburn in Cambridge (where both of my children were born), the price was $971.96. At Diagnostic Ultrasound Associates, the stand-alone imaging center in the Longwood section of town, I was told the price was $519. (After I posted my story on the Savvy site, I got a note from the interim CEO of another Harvard teaching hospital, Beth Isreal Deaconess Medical Center, who said at his hospital, the test would be $307. Sold.)

With national health reform unfolding, and pressure mounting for greater price transparency and lower costs, patients are being pushed, inexorably, to become smarter health-care shoppers. Right now, most of us still have “no skin in the game” as the policy types like to say, meaning, essentially, we don’t feel the pain of paying for our health care. Sure, we cough up cash for co-pays and deductibles, but for the majority of families and individuals, insurance pretty much covers the bills and we remain blithely ignorant about what our health care actually costs.

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My Ultrasound: Three Tests, Three Pricetags

By Rachel Zimmerman

My doctor said I needed a pelvic ultrasound.

Fine, I said. Do you know how much it’ll cost?

No idea, she said. But you can ask.

Great, I said. I love comparison shopping (especially when I don’t have to pay).

To be honest, I never would have shopped around for an ultrasound if not for my colleague Martha Bebinger. She’s just launched the cool, forward-thinking, social networking site, Health Care Savvy, which will serve as a forum for patients to compare prices, brainstorm on how to get costs under control and generally vent.

So, motivated to become a savvier health care consumer, I set out on my journey.

1. Insurance

My family has Blue Cross Blue Shield of Massachusetts health insurance through MIT, where my husband works. So, the first thing I did was to call the referral office to find out what my options were for getting the ultrasound. (The details of why I needed the ultrasound aren’t necessary here, believe me. Suffice to say there were some questions about minor bleeding. But don’t worry, it turns out everything’s OK.)

I had three choices: Massachusetts General Hospital in Boston; Mount Auburn Hospital in Cambridge; and Diagnostic Ultrasound Associates in the Longwood area. I asked the nice referral lady what the costs were at each. Call billing, she said. At referrals, no one has the prices for services.

2. Billing

All of Billing seemed to be on vacation. At least that’s what I figured since I pressed all of the possible extensions available and got no human voice. So I went back to referrals and talked to someone else who told me, eagerly, my ultrasound wouldn’t cost a thing, no co-pay, nothing. “I don’t want to know what it costs me, I want to know what it costs,” I explained. Silence. I was told to call each medical facility separately for that.

3. Three Prices

I called each facility, and here are the prices I was quoted for a pelvic ultrasound:

–Mass. General: $2847 or $2563 (more on this later)
–Mt. Auburn: $971.96
–Diagnostic Ultrasound Associates: $516

All three quotes were for the imaging only and did not include professional services or other additional costs, I was told. Continue reading

From Boston Midwife, Medical Cost Horror Story #3: ‘Unnecessary’ Ultrasounds Lead To Empty Cupboards

Tarcia Edmunds-Jehu, a Boston nurse-midwife, captures beautifully how the current health care system leaves patients struggling desperately to pay bills — and providers feeling terrible that their well-meaning care is to blame. Read her here.

This is the third finalist to be posted in the essay contest by Costs of Care, a local non-profit organization. (Read about the first two here and here, and the overall contest here.)  An excerpt:

Tears begin to flow and she starts to talk. She tells me that she had been in this country for 5 years and never had public assistance of any kind. She talks about her long hours working 2 and sometimes 3 jobs in order to have enough money to keep her family afloat. She talks about putting herself through school to become a CNA while still working to pay her bills. Until last year she was doing this alone, making not only money to provide for her family, but also the money needed to bring her husband here. She had never asked for help or let her children go without. But now she is unable to pay her bills and buy food. What is the tipping point for her ability to provide for her family?

Three ultrasound bills from this pregnancy.