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VIDEOS: OBAMACARE, HEALTHCARE EXCHANGE ISSUESPence: Health Care Setback 'Won't Last Long' | 2:14

A defiant Vice President Mike Pence says President Donald Trump's administration is refusing to accept defeat on health care. (March 25) AP

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House Speaker Paul Ryan cancelled the vote on the GOP's health care bill that would've replaced Obamacare, saying he could not get enough votes to support it. USA TODAY

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House speaker Paul Ryan explained his decision for cancelling a vote on the GOP bill to replace Obamacare. USA TODAY

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The nonpartisan Congressional Budget Office found that the changes recently introduced to the GOP's health care bill could add billions of dollars to the bill's cost, without increasing the number of those insured. USA TODAY

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President Donald Trump gave a speech at the National Republican Congressional Committee in Washington Tuesday night, telling the crowd the American people gave "clear instructions" by electing Trump to "get to work and to get the job done." (March 21) AP

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Republicans released a modified health care bill in an attempt to shore up bipartisan support to replace the Affordable Care Act. USA TODAY

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Concerned citizens protest the GOP health care plan. Nikki Boertman/The Commercial Appeal

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Republicans are starting the process of replacing the Affordable Care Act but there is some dispute within their own party about how to proceed.

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While holding a press conference after touring Fort Campbell, US Congresswomen Marsha Blackburn and Diane Black did not answer questions about new healthcare law. Shelley Mays and Jake Lowary

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House Republicans have unveiled their replacement plan for the Affordable Care Act. The plan differs from Obamacare in various ways. Time

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A new poll from MTSU shows that, in Tennessee, opinions are often tied to your political affiliation. Adam Tamburin/The Tennessean

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Protesters rally outside Senators Bob Corker's and Lamar Alexander's offices in support of the Affordable Care Act. George Walker IV / The Tennessean

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When will America get a new healthcare plan? President Donald Trump is now saying it could be a year from now. Aaron Dickens reports. Buzz60

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The prospect of repeal has made Obamacare more popular than ever! Rob Smith has all the details. Buzz60

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GOP Congress Members recently introduced legislation that would give the authority to states to keep ObamaCare. Jose Sepulveda (@josesspulveda87) has more. Buzz60

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Gov. Bill Haslam is calling on Congress to cede more control over health policy and regulation to the states, as the debate over repealing or replacing the Affordable Care Act rages on in Washington. Wochit

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Chris Kane had insurance through Community Health Alliance before it went defunct then moved to Blue Cross Blue Shield Tennessee, now will have to go to Humana. He has concerns about finding the right doctors for his family, a wife and infant. Amy Smotherman Burgess / News Sentinel

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The health care heavyweight is grappling with hefty losses and ongoing uncertainty on the marketplace. Karen Kraft / The Tennessean

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Changes to the Affordable Care Act in Tennessee Kyleah Starling/ The Tennessean

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Insurance broker Jonathan Katz of Virginia Medical Plans speaks with USA TODAY healthcare reporter Jayne O'Donnell about some the problems facing those enrolling for Obamacare. USA TODAY

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Five states are expected to have just one company selling insurance on the 2017 Obamacare exchanges and consumers in most of the counties in nine other states won't find any competition for their exchange business either. Martin E. Klimek, USA TODAY

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Pence: Health Care Setback 'Won't Last Long'

GOP health care vote pulled at last minute

Paul Ryan: 'We came up short' on health care vote

CBO says latest GOP health care bill would cost more

Trump: Health care bill ends Obamacare nightmare

GOP's modified health care plan includes key changes

Memphians say no to Trump Care

The debate begins over Obamacare replacement

Tennessee lawmakers decline to talk about new healthcare law

What to know about the GOP healthcare bill

MTSU poll addresses Obamacare

Obamacare rally in Nashville

Obamacare may not be replaced until next year

Why Obamacare is more popular than ever

Potential GOP ObamaCare replacement wouldn't really 'replace' it

Haslam: States need more control over health care

BCBST departure from 3 metro areas

BlueCross BlueShield of Tennessee is leaving the Obamacare marketplace

Obamacare Exchange 'Very Near Collapse'

Obamacare exchanges still troubled by enrollment issues

As insurance companies dwindle, patients left frustrated with lack of choice

Price blindness, or a lack of price transparency, affects healthcare consumers across the U.S. Pricing is so opaque that even many doctors and hospitals cant estimate what a service might cost, leaving patients no options to compare or price-shop.(Photo: Getty Images/iStockphoto)

This month, local price transparency company Healthcare Bluebook launched its price comparison tool for residents of Middle Tennessee and Southern Kentucky.

In providing its full database, Healthcare Bluebook has created an opportunity for Nashville consumers to cure what the company has coined as price blindness, or the inability to evaluate what a medical procedure will cost before receiving it.

With the free tool, consumers in Nashville and the surrounding regions can easily search for common medical procedures and find fair prices as well as rankings of area hospitals and other provider sites to see how they compare on price and quality.

This is the first time any community has been able to access the companys comprehensive database of pricing and provider information, which was previously only available through employers as a workplace benefit.

Price blindness, or a lack of price transparency, affects healthcare consumers across the U.S. Pricing is so opaque that even many doctors and hospitals cant estimate what a service might cost, leaving patients no options to compare or price-shop.

This problem is unique to healthcare can you imagine driving a car off the dealers lot and getting a bill in the mail later? Would you buy a television at Best Buy without a quick Amazon search? Most of us would not, but until recently, there just wasnt a way for consumers to easily compare costs in healthcare.

But Nashville companies like Healthcare Bluebook and MD Save are trying to change that, especially as consumers pick up more of the costs of their care. With higher deductibles and more cost-sharing, patients are starting to ask questions about how much services cost, and if they can be provided at a lower price elsewhere.

Heres an example: How much does a total knee replacement cost in Nashville? According to Healthcare Bluebook, the fair price, or what you might reasonably expect to pay, is $34,357, but costs in the area range more than $20,000 from $22,044 to $54,545.

Because there is so much variation in cost depending on your insurance plan and other individual factors, Healthcare Bluebook doesnt publish the specific cost estimates at each Nashville hospital. But the company does rank the facilities, based on how much more or less than the fair price the service is expected to cost there. This can be very enlightening.

For example, for our knee replacement, only Saint Thomas Midtown is expected to cost at or below the fair price. Not even a mile away, Vanderbilt University is in the red, or expected to have the highest price.

Heres another procedure. How much would you expect a rotator cuff repair surgery to cost? Here, Healthcare Bluebook shows that all the local hospitals Saint Thomas, Vanderbiltand TriStar are the highest-priced sites of care. But outpatient facilities, like Nashville Surgery Center, Baptist Plaza Surgicare, Centennial Surgery Center and St. Thomas SurgiCare are all at or below the fair price of $8,296.

Lets look at one more example, an MRI. Its particularly smart to price shop imaging services, because there can be massive cost variations for something that many regard as being relatively straightforward. As with the shoulder surgery, a chest MRI is far more expensive in the hospital than at an outpatient site. Heritage Medical Associates, Premier Radiologyand the Outpatient Diagnostic Center of Nashville are all expected to be at or below the fair price of $900.

Why are hospitals more expensive than outpatient settings? Generally speaking, its because they have more overhead. Outpatient sites are typically smaller facilities with fewer staff and less expensive equipment. Often, the higher cost of a basic MRI at a hospital is actually subsidizing much more expensive technology.

This is also why some hospitals are more expensive than others. Hospitals with more robust or advanced services, like pediatric cancer treatment or state-of-the-art cardiac care, have more leverage with insurers and can negotiate higher payments for all services.

This leverage is largely driven by the employer-based group insurance market. Because employers want to provide employees with access to cutting-edge treatment, they demand insurers include them in their plan networks. Because providers know the insurers wont exclude them, these hospitals are able to negotiate higher payments.

Eventually, this all trickles down to you via your out-of-pocket costs. Many insurers and employers hope that consumers will soon become more comfortable comparing healthcare costs, and begin choosing less expensive options.

Healthcare Bluebook is a great tool for Nashville consumers to do that. By getting a sense of fair prices, consumers can cut through those complicated negotiations and get to the heart of the matter how much will it cost?

Alex Tolbert is the founder of Bernard Health, a company that provides non-commissioned, expert advice on health, Medicare and COBRA insurance and medical bill consulting. To learn more, visit http://www.bernardhealth.com.

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Read more:
Can Nashville find cure for price blindness in health care? - The Tennessean

This entry was posted on March 27, 2017 at 3:48 am and is filed under Blindness. You can follow any responses to this entry through the RSS 2.0 feed. Both comments and pings are currently closed. |