Claremore Daily Progress

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October 25, 2013

Patients, firms shop for better health care deals

(Continued)

OKLAHOMA CITY —

Advocates say all the shopping will help control medical spending.

“We waste an enormous amount of money in this country by overpaying for health care,” says John Goodman, an economist and CEO of the National Center for Policy Analysis. “The only way to get rid of waste is to have people compete in a real marketplace.”

Searching for health care deals is a big change for many patients who’re used to paying whatever their insurer didn’t. Just figuring out an appropriate price for a procedure can be difficult for the average person.

Surgeries and other major procedures have different prices based on a variety of factors, including whether it’s performed in a big city where care can cost more or in a hospital. And the portion that patients pay can vary widely. A lot depends on the type of insurance coverage and other factors like the leverage a provider has in negotiating rates.

For instance, a patient in Detroit with high-deductible health coverage provided by an employer could pay $920 or $2,791 out of pocket for a colonoscopy, according to research done by health care technology firm Castlight Health. Same patient. Same insurance coverage. Only difference: Where the procedure is performed.

“You can be a highly educated consumer now and still not understand what bill is going to hit you,” says Dr. Giovanni Colella, CEO of Castlight, which designs an application that insurers or employers can give to patients to help them shop for health care based on price and quality.

It’s also tough for patients to measure quality versus price. “You may find something (more expensive), but it doesn’t mean it’s better, safer, or more efficient,” says Arthur Caplan, a medical ethicist at NYU Langone Medical Center.

Insurers and employers are encouraging workers to become more educated. They say quality is a priority when they ask patients if they want a better deal.

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