Seeking the Best Medical Prices

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Seeking the Best Medical Prices

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Health care consumers are encouraged to comparison-shop on things like doctor's ... When Ms. Kyser needed a routine gynecological exam, she called a handful of ... – PowerPoint PPT presentation

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Title: Seeking the Best Medical Prices


1
Seeking the Best Medical Prices
  • By WALECIA KONRAD
  • Published November 27, 2009

http//www.nytimes.com/2009/11/28/health/28patient
.html?hpw
2
Comparison Shopping?
  • Health care consumers are encouraged to
    comparison-shop on things like doctors fees and
    heart surgery rates. But unfortunately, most of
    us have little clear or useful information to go
    shopping with.
  • When you go to the doctor, how much you fork
    over when all is said and done is often just a
    mystery, said Dr. Anthony P. Geraci, a Manhattan
    neurologist who is trying to buck that trend by
    posting his prices on his Web site.
  • With the growing number of uninsured people, the
    increase in high-deductible insurance plans and
    big jumps in co-payments, just about everybody is
    paying more out of pocket for health care
    nowadays. An estimated 15 percent of adults
    younger than 65 now pay with their own money
    medical costs greater than 5 percent of their
    annual household income, according to the Center
    for Studying Health System Change, a nonpartisan
    research group in Washington.

3
Routine Exam?
  • Katie Kyser, 30, the mother of a year-old
    daughter, lives north of Seattle. She and her
    husband, Jason, who works in construction,
    recently moved from California. They have no
    health insurance, so they pay all costs out of
    pocket.
  • When Ms. Kyser needed a routine gynecological
    exam, she called a handful of local doctors, all
    of whom were charging 200 or more. Theres no
    way we could pay that, Ms. Kyser said. I had to
    find another way.
  • Having seen an ad for PriceDoc.com, a new Web
    site that lists doctors throughout the country
    who are willing to post their prices and
    negotiate with patients, she decided to try it.
    Ms. Kyser found a nearby clinic where doctors
    charged only 75 for the exam.

4
Medical Pricing a Quagmire
  • Medical pricing is a quagmire, oozing with jargon
    and current procedural terminology codes. Just
    look, if you dare, at your latest explanation of
    benefits from your insurer.
  • Whats more, rarely is there one standard price
    for a medical treatment. Prices vary based on
    geography and type of provider whether
    hospital, stand-alone clinic or any alternative.
  • Then, doctors, hospitals and other providers may
    negotiate different rates with different
    insurers. It is not unusual for a provider to
    have 10 or more different prices for the same
    procedure, depending on who is paying. Providers
    often charge a completely different rate for
    people paying on their own, which is almost
    always much more expensive than the discounted
    rate that insurers pay.

5
The Economics
  • What gives a firm market power?
  • Lack of a substitute!
  • Market price is related to the elasticity of
    demand.
  • What happens to quantity if you raise price?

P
Q
6
Compare shopping decisions for
  • Medical Care
  • Personal Computers
  • Memory Sticks
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