DATE : February 26, 2019
Costs for the exact same procedure — an MRI of a knee — vary dramatically among area hospitals, according to a new report that calls for more transparency and action to bring down health costs.
Boston's Pioneer Institute released a report on Tuesday that looked at the price of a knee MRI in 2015 at 14 local hospitals, finding that both the out-of-pocket costs and the amount insurers have to pay is far more at the big-name hospitals — though the two amounts have little to do with each other.
Out-of-pocket expenses range from just over $55 at Mount Auburn in Cambridge to $205 at South Shore in Weymouth, according to the report. But both of those places fall toward in the middle of the pack in terms of total cost, further complicating the financial picture, the authors wrote. The least expensive in terms of total cost is St. Vincent Hospital in Worcester at $475, versus Boston Children’s Hospital $1,423.
Report author Barbara Anthony says neither of those sets of information is commonly available for easy comparison. She said employers offering health care coverage can save money by providing incentives to people who go toward the lower overall costs — and help bring down health-care costs in general along the way.
“Provider prices are the reason our health care is so expensive,” said Anthony, who wrote the report along with Scott Haller and Kaila Webb of the institute. “It’s chaos in the healthcare pricing system.”
She said companies could ultimately gain from offering money or other carrots to people who take the less-expensive options.
Anthony, who focuses on health care and consumer-protection issues for Pioneer, told the Herald that the players across the board — providers, insurers and employers — need to make a push to make it easier to compare.
“Insurance companies and employers have to make it easy for employees to know where to go to get low-cost, high-value health care,” Anthony said.
The report also calls for a public push for this, saying the millions of Bay Staters under the three main insurance companies only attempted 297,000 estimate inquiries in three years.
“State government and industry leaders must undertake a substantive, ongoing public education campaign to elevate the importance of price transparency in our discourse around healthcare choices,” the report states. “Consumers are not used to shopping for healthcare, so despite the existence of insurer tools and provider estimates, people simply don’t use them very much.”
The data used in the report comes from the Massachusetts Center for Health Information and Analysis and its all-payer claims database, called the APCD. The report calls for the government to make the APCD data available to the public.
- Sean Philip Cotter, The Boston Herald, February 26, 2019