October 28th, 2009
The fight for medical cost transparency is coming online
When conservatives criticize health reform one of the first things they suggest might work is greater transparency in health care costs.
Sites like Healthcarebluebook.com and Changehealthcare.com have been trying to offer this service for some time.
Procedures like MRIs, CT scans, colonoscopies, minor orthopedic surgeries and mammograms can all be shopped with these resources. You can also compare drug prices and learn what to do if a medical claim is denied.
Increased deductibles are giving more families a reason to consult these resources. But they are only a partial answer. Insurers control most costs through their repayment schedules.
This is where government action has proven necessary. But not national government action.
After Ingenix, a unit of UnitedHealthCare, was caught manipulating its repayment rates, New York Attorney General Andrew Cuomo won a settlement that includes a third-party estimate of what insurers should be paying.
That national database, to be called FAIR Health, will debut in about a year under a contract signed recently with Syracuse University and other state universities. The database will calculate “reasonable and customary” charges, based on location, eventually replacing Ingenix.
While Ingenix was used only within the industry, FAIR Health will be available to the public, so you can compare your own doctor’s charges to the market.
Reform and cost controls are a big problem with a lot of moving parts. Most experts agree broadly on what needs to be done. Comparative effectiveness is one tool. Price transparency is another. These are moving ahead regardless of what happens in Washington.
Dana Blankenhorn has been a business journalist since 1978, and has covered technology since 1982. He launched the Interactive Age Daily, the first daily coverage of the Internet to launch with a magazine, in September 1994. See his full profile and disclosure of his industry affiliations.
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| 10/28/09
