New tool searches health prices by doctor, insurance
Starting Tuesday, consumers worried about high out-of-pocket health costs can search for procedure prices, from knee surgeries to vasectomies, based on their doctor and type of insurance so they can eliminate most of the surprise bills that show up long after their wounds have healed.
Amino, a health data company that launched last fall, already was helping connect patients to doctors in their areas based on quality data. The new tool expands its pricing data and covers about 550,000 physicians, 49 procedures and 129 insurance companies.
While Amino is one of many public and private entities trying to help consumers shop for health care, its new tool gets as close as any have come yet to having such a wide range of details.
The information is based on hundreds of millions medical insurance claims, totaling $860 billion within the last year, to help patients plan for the seemingly never-ending series of bills that follow patients after any major procedure.
“Gaining access to pricing information has proven incredibly difficult,” says Amino CEO and co-founder David Vivero. “Industry efforts at price transparency have missed the mark.”
Physician Neel Shah, who founded the non-profit Costs of Care, called Amino’s effort “an important first step.”
“Most of the way costs are communicated are not really using the language patients use,” says Shah.
Amino gives users several opportunities to click for more information about insurance and other terminology used. Whether a patient is uninsured or uninsured, Vivero says the goal is to give them “a leg up” when they visit their doctor’s office.
Vivero agrees with Shah, who says “it’s always hard to know what all the costs are going to be” because a doctor may not know what a patient’s full needs are until they’ve been evaluated. And even then, new issues may arise while a patient is under anesthesia. That’s why Vivero says it’s an estimate based on all the other people with the same insurance who went to the same doctor for the same procedure.
Shah says physicians can help too by doing a “better job explaining the range of possibilities” of what a procedure could involve — and cost.
Health care costs are a challenge even for the experts to figure out. Elizabeth Munnich, an assistant professor of economics at the University of Louisville, says costs vary — even within the same hospital — because they are largely based on insurer negotiations with health care providers. So the mix of insurers, and the relative power of those insurers and the hospital system, influence prices.
While shopping around for care based only on cost can carry risks, Charles Kodner, who practices family medicine with the University of Louisville Physicians, recommends that patients press their physicians on whether it’s necessary to “do the tests right now.”
Even with all the tools available, Munnich says she doesn’t think health care costs will ever be “fully transparent.”