You can’t put a price on an open-heart surgery that saves your life — not yet, at least.
There’s a growing push to provide patients with the tools they need to become better consumers and make more informed decisions about their health care.
Employers are asking their workers to pick up more of the health bills through higher deductibles and out-of-pocket charges.
Consequently, patients are demanding more information because they have more of their own money on the line, said David M. Garratt, vice president of the Ohio and Kentucky markets for Aetna, one of the nation’s largest health insurers.
“In order to make the right decisions, consumers need to know more about price and quality,” Garratt said.
Insurers, employer coalitions, the federal government and others are responding by offering e-reports that provide clues about the quality and cost of care on a regional basis and, in some cases, down to the hospital level.
Medicare, the federal health insurance program for people 65 and older and some younger disabled Americans, already has been offering some quality comparison information for hospitals, nursing homes, home health agencies and dialysis centers through links on its Web site, www.medicare.gov.
This summer, Medicare launched the first phase of an enhanced Web site with hospital pricing information.
For now, consumers can use the site to see the range Medicare pays hospitals within a specific county and state for some of the most common procedures and treatments.
Additionally, the federal site shows how many people with various conditions are treated at each hospital annually.
Eventually, the government wants to work with insurance companies and employer and consumer groups to share comparable cost and quality information down to a hospital level, said Mike Leavitt, secretary of the U.S. Department of Health and Human Services.
“People need to know how much their health care costs,” he said during a recent national conference call. “They need to know the quality of the care they receive. And they need to have a reason to care. Consumers making a decision today often make a decision with little or no information.”
Despite the limitations, insurance companies also are trying to provide their members with some tools to estimate the cost of their care.
Aetna, for example, has launched a program that allows some enrollees to visit a Web site and view Aetna’s discounted payment rates to individual doctors for common doctor-office services, such as basic visits, X-rays and lab tests.
The information can be particularly helpful for consumers with high-deductible plans who must spend their own money or funds from special pre-tax health savings accounts before insurance coverage starts.
“Price transparency is one of the elements consumers are looking for,” Garratt said.
Likewise, national insurance giant United HealthCare offers members access to an online cost estimator that shares the average national cost for all the care associated with common procedures.
Numerous other Web sites also rank hospitals’ quality based on how well patients fare, as well as whether the facilities follow nationally recognized standards for providing care.
Nevertheless, most consumers aren’t comparison-shopping for health care the same way they do for a new car or a plasma TV, especially in emergencies.
“Are you really going to go around and shop hospitals based on price?” asked Trudy Lieberman, director of the Center for Consumer Health Choices for Consumers Union. The consumer advocacy group publishes Consumer Reports magazine.
Consumers still pick hospitals based on their doctor’s referral or insurance coverage, she said.
But the cost estimator tools do help raise awareness about the actual high cost of care.
The Pennsylvania Health Care Cost Containment Council Web site contains a wide variety of reports on the cost and efficacy of medical procedures performed in hospitals. Visit www.phc4.org