One of the major things wrong with the American healthcare system is that nobody knows the prices of healthcare services until healthcare has already been performed. Healthcare providers in the USA provide great services to their patients, but it is almost impossible to know the costs beforehand. The lack of data comparing prices makes it even harder. There are official data released that compares each state’s average price of healthcare services against the national average, but that doesn’t really help anybody know exactly what they will pay when they visit the doctor. Medical cost comparison must become a standard part of how we find and receive healthcare, or the system will not be sustainable.
According to Clear Health Costs, a credible journalism group that gathered prices in ten metro areas, the price for a basic MRI within a 100-mile radius of San Francisco ranges from $500-$6,000. A service can cost 50 to 100% more only because it’s done at a hospital instead of an independent center. The prices can widely vary per location, thousands of dollars even. But how is anybody expected to know that until after they get the bill?
When providers and insurers negotiate prices of medical treatment services just between the two of them, that’s when things can get a bit inconsistent. The Institute of Medicine found that about 70% of the variation in medical treatment pricing trends is due to differences in prices set by doctors and hospitals. Healthcare Providers are allowed to charge whatever they want for healthcare services. We as customers can’t directly control this pattern, but we can be knowledgeable healthcare spenders by doing our homework. And when consumers are more in the know about the options for their healthcare, we can see how providers will gradually begin to be more upfront about their prices at the start. It’s a win-win situation.
ZeaMed wants to do your homework for you and help get you ahead of the game. We want you to have the smartest and simple experience possible, and we will do just that by providing quality-price transparency you so desperately deserve.
The Health Care Cost Institute (HCCI) won’t disclose which hospitals or doctors are the high-price culprits and instead are releasing how much states’ average prices differ from the national average.
Clearhealthcosts.com, which compiles prices in 10 metro areas using data from consumers, doctors,, and hospitals and its own staff members’ research, finds a huge price disparity within a 100-mile radius of San Francisco for some procedures.
This research and data is not clear enough
According to Clearhealthcosts.com, the price for an MRI within a 100-mile radius of San Francisco ranges from $500-$6,000. Colonoscopies can cost 50 to 100% more just because it’s done at a hospital rather than an independent surgery center.
When consumers are more in the know about the options for healthcare, providers will be urged to be more upfront about their prices
“One of the things that are a barrier is that hospitals and insurers have an incentive to negotiate behind closed doors,” says Shah, who is also the founder of the global nonprofit Costs of Care.
In a 2013 report on health care spending, the Institute of Medicine (IOM) reported about 70% of the variation in spending in the commercial insurance market is due to differences in price markups by doctors and hospitals, which it said most likely reflects these providers’ regional market power. IOM is part of the National Academy of Sciences, which were chartered by Congress to advise the government and private sector.
Hospitals negotiate the cost of medical treatment services with insurance companies. And, the new report found that healthcare procedure & Medical treatment prices at hospitals in monopoly markets are 15 percent higher than those at hospitals in areas with at least four providers.
“These price differences between hospitals can be thousands of dollars,”
For example, the price of an average inpatient stay where there’s a monopoly hospital is almost $1,900 higher than where there are four or more competitors. We know that these higher prices end up getting translated into higher premiums that employers pass on to workers.