How Much Does That X-Ray Cost?
Written by Editor   
Tuesday, September 23, 2014 04:13 PM

When Anthem Blue Cross Blue Shield became embroiled in a contract dispute with Exeter Hospital in New Hampshire in 2010, its negotiators came to the table armed with a new weapon: public data showing the hospital was one of the most expensive in the state for some services.  When the dust settled, the insurer had extracted $10 million in concessions from Exeter.

The hospital "had to step back and change their behavior," said health policy researcher who studied the state's efforts to make healthcare prices transparent.  New Hampshire is among 14 states that require insurers to report the rates they pay different healthcare providers -- and one of just a handful that makes those prices available to consumers. The theory is that if consumers know what different providers charge for medical services, they will become better shoppers and collectively save billions.

In most places, though, it's difficult if not impossible to find out how much you will be charged for medical care. In many cases, the data is limited or is restricted to enrollees in specific health plans. That's why business groups in almost two dozen additional states have sought laws to require insurers to report what they pay providers.

New Hampshire's HealthCost website, which launched in 2007, shows median prices paid by insurers for 40 procedures, including emergency room visits, mammograms and outpatient knee surgeries. Prices are shown for every hospital, as well as for many freestanding surgical facilities and imaging centers, where patients go for tests such as x-rays.  For those with insurance, the website lists the potential cost to patients based on their plan deductible -- as well as to their insurer. Uninsured consumers can also see what they might pay, including any charity programs that might apply. 

Source:  http://www.medpagetoday.com/PublicHealthPolicy/HealthPolicy/47750