Friday, November 27, 2009

Shopping Around for the Best Prices in Medical Care - NYTimes.com

CAN you really shop for doctors and hospitals the way you would for airfares and flat-screen TVs?

Health care consumers are encouraged to comparison-shop on things like doctor's 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.

So the typical person is probably far more motivated to ask how much an M.R.I. or a hip replacement costs. And just as often, people are asking — or should be — "How can I get a better price?"

Take Katie Kyser, 30, the mother of a year-old daughter, who 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. "There's 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.

"I was a little nervous at first because the price was so cheap, but when I got there, it was wonderful," Ms. Kyser said. "Everyone was so professional and helpful."

The crucial part of shopping wisely for health care (or anything else for that matter) is comparing prices the way Ms. Kyser did.

But that is also where problems arise. 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.

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http://www.nytimes.com/2009/11/28/health/28patient.html?hpw=&pagewanted=print