If you’re like most people, you’re taking more responsibility for and picking up more of the tab for your health care. A growing number of Web sites can assist your efforts by showing how the price and quality of care offered by different providers measures up.
1. Insurer sites
Many health insurers have member sites, says Carlton Doty, vice president and research director with Forrester Research Inc. While their capabilities vary, most include educational content as well as information on average prices for different procedures. If you’re insured, you’ll want to start your research here because the information should be most relevant to your situation, Doty says.
Aetna Navigator, the member site of Aetna Inc., for instance, lets members in more than 30 states compare prices charged by different health care providers. For example, the overall cost of a colonoscopy at one surgery center ran $1,200 to $1,800. The same procedure at a nearby hospital was $2,240 to $2,800.
The figures are based on two years of claims data, from which any extreme outliers have been removed, says Wayne Gowdy, senior product manager with Aetna. The site also offers information on the number of procedures performed at a hospital or clinic over a time period, as well as quality ratings. Aetna also offers a tool that lets members compare drug prices.
2. Government Web sites
A number of states, along with the federal government, host Web sites that provide price and/or quality information. For example, Wisconsin PricePoint lets residents of America’s Dairyland search more than 100 procedures at different hospitals, urgent care centers and emergency rooms. Use of the site is free.
For each facility and procedure, the site lists the range of prices charged, as well as the number of procedures completed, and the average and median length of stay. The figures are based on data the hospitals are required to provide to the government, says Joe Kachelski, PricePoint’s vice president. While he and his staff double-check numbers that look out of whack, they don’t eliminate outliers.
Again, the price differences can be significant. Case in point: Treating an ear infection at one urgent care center runs about $111. It’s $450 at the emergency room down the street.
3. Independent Web sites
A number of companies also operate sites. Healthgrades.com, for instance, assigns quality ratings of one, three or five stars to around 5,000 hospitals across the United States, using data the hospitals submit to the Federal or state governments.
To calculate the ratings, Healthgrades’ team adjusts the information to account for differences in patient population, says vice president Sarah Loughran. For example, one hospital may serve a largely elderly population, and age usually affects patient outcomes.
Then, Loughran and her staff will look at data on survival and complication rates, among other factors. Based on this, they’ll run the numbers to determine whether a particular hospital, given its patient population, performed as expected (three stars); better than expected (five stars); or worse than expected (one star). Most information is free. The Web site also provides information on physicians and nursing homes.
For nearly all procedures, about 12 percent of hospitals earn five stars, another 12 percent get one star and the rest come in with three stars, creating a pretty distinct bell curve, Loughran says. The differences between the ratings can be meaningful. A 2008 study by Healthgrades found that patients’ chances of dying are 70 percent lower at top-rated hospitals than at lower-rated ones.
4. Consumer reviews
Several Web sites have added consumers’ reviews of health care providers. AngiesList.com, which got its start providing reviews of home repair companies, now offers members’ reviews of doctors, including such information as cost, the length of time spent waiting in the exam room and the staff’s helpfulness. Similarly, Yelp.com, which originally offered reviews of restaurants and clubs, now provides members’ assessments of their doctors in some cities.
Not the whole story
Most experts agree that while you can use these reviews to complement what you learn elsewhere, it would be foolhardy to rely on them. You need to look at medical outcomes, says Valerie Wedin, national health care communications champion with Watson Wyatt.
Clearly, you should expect that doctors’ appointments will proceed reasonably promptly and that the staff will treat you respectfully. However, it could be dangerous to avoid a qualified professional because one reviewer had an unpleasant experience.
While all these Web sites can help when you’re choosing health care providers, they’re not perfect. For starters, to accurately determine your cost, the sites would need to factor in your health care plan, as each plan negotiates different rates with providers. Instead, most sites give a range of prices across networks.
What’s more, measuring the quality of health care isn’t straightforward. Doctors worry that their ratings may suffer if, for instance, they take on patients whose conditions are more complicated. And, if a measure includes only small groups of patients, the results can be skewed by a few extreme cases.
Even so, measuring and reporting quality can make a difference. One report, “The State of Health Care Quality 2008,” by the National Committee for Quality Assurance in Washington, D.C., found that for the ninth consecutive year, health plans that reported quality measurements provide better care. To take one example, the report estimates that between 76,000 and 132,000 lives were saved between 1996 and 2007 as a result of blood pressure control measures put in place by what it calls “accountable plans,” or those that report quality measurements.
That’s why, despite the imperfections in the current methods for measuring health care cost and quality, it’s critical that they continue to improve. Many of the variations between patient populations can be adjusted for, making the ratings more meaningful. Moreover, the notion that patients should remain in the dark no longer is acceptable, says Josh Seidman, president of the Center for Information Therapy in Bethesda, Md. “It’s important to continue to push the envelope and make the systems better and do that in a public, transparent way.”