Texas Web Site Lets Healthcare Consumers Shop Around

I have written a previous note about Health 2.0 (see: Introduction to Health 2.0). It's  a complex topic but generally encompasses the concepts of empowerment of healthcare consumers, price transparency, and the integration of the decentralized islands of healthcare clinical information stored in multiple healthcare delivery venues. Dr. Scott Shreeve, one of the most prominent promoters of Health 2.0, has written a note about some of the  change agents or enablers of Health 2.0 (Health 2.0: Change Agents of the New Paradigm). Simply put, these are largely web-based resources that support healthcare consumers in various ways, often by providing the information necessary to assist them in making informed choices about their health. A recent article (see: Web site lets hospital patients shop around) discussed a web site called Texas PricePoint that enables healthcare consumers to shop intelligently for services by price (boldface emphasis mine):

A new Web site launched by the Texas Hospital Association in Austin will allow health care consumers to view and compare prices on inpatient hospital services at Texas hospitals. The Web site, Texas PricePoint, includes charge data on the most common inpatient services, links to data and general information on all Texas hospitals....Through basic and advanced queries, users can request information on a single hospital or look at multiple hospitals to compare information. Users also have the option of clicking on a link to the hospital's own Web site if one exists. The site uses hospital-supplied data, updated quarterly, from a variety of sources including the Texas Health Care Information Collection and the Centers for Medicare & Medicaid Services. It's operated under contract with WHA Information Center, a subsidiary of the Wisconsin Hospital Association

Web sites such as Texas PricePoint are all about the transparency of the pricing of healthcare services. In a previous note (see: Bargaining Down the Cost of Your CT Scan), the discussion focused on the importance of knowing the discounted rate that was obtained for a service such as a CT scan by commercial insurance carriers or Medicare. Armed with this knowledge, the consumer is then well positioned to request a similar discount. Such a strategy is particularly relevant when the consumer has a high-deductible health plan coupled to a health savings account. For the uninsured, negotiating a discount can be an absolute necessity. Another option would be to consider medical tourism whereby one would travel to a high-quality overseas hospital for an elective or semi-elective surgical procedure.

Texas PricePoint offers the following advice on its web site to uninsured consumers, and actually forces them to read this material before proceeding:

• For patients who do not have insurance, hospitals typically offer discounts. Some discounts may be based on the patient’s income level and family size.
• You should contact the hospital’s business office for information on the hospital’s policies and how to request a discount. In some cases, you may be asked to verify income or other assets to determine whether or not you qualify for full or partial financial assistance.
• Access on-line information provided by the Texas Department of Insurance to help you shop for health care coverage at www.texashealthoptions.com.

Here's some information from another web site (see: How to Cut Your Health-Care Costs) about negotiating strategies when the need arises to go out of your network:

...[T]here may be times when you need to go out-of-network. What can you do? Negotiate. Ask your doctor to lower his or her fee. You'll be surprised to see how much wiggle room there can be....The key to negotiating successfully is knowledge. Call your insurer and ask a customer-service representative how much the company will cover for the type of service you need. Then pass that information along to your doctor. If your doctor isn't willing to come down in price, you may want to find a physician who will. Certain insurers will even help you shop around. Cigna, for example, offers a cost-comparison tool on its Web site.