An online health care cost comparison tool launched two years ago in response to rising medical costs has expanded its database to include the price tags for more than 600 outpatient procedures across the country, including in West Virginia.
Dr. Bill Hennessey, a practicing physiatrist in Greensburg, Pennsylvania, who also sees patients in Morgantown, said the hidden costs of health care can keep people from the care they need.
He said many are unaware of their options, which include hospitals, private physicians, ambulatory surgery centers, independent imaging centers and independent lab centers.
“Outpatient procedures is a fixed commodity market. It’s a fixed amount of time, effort and the same machinery, and there shouldn’t be such variations — sometimes thousands of dollars — for the same care,” he said.
Two years ago, Hennessey launched www.pratter.us as a way for health care consumers to compare hospitals and other providers within a ZIP code on the cost of procedures. Its blood testing comparison tool, which includes a range of common blood tests, returned costs for testing magnesium levels within 10 miles of Charleston that range from $17 to nearly $390.
“What I want to see pratter do is a couple things: No. 1 is that known pricing creates smart shopping. With enough pratter participation, known pricing will create competition, and we can all sit back and let hospitals and surgery centers compete for our health care dollar,” Hennessey said. “Right now, without known pricing, the tail is wagging the dog.”
Hennessey said one of the big obstacles to price transparency has been convincing hospitals and insurance companies to fork over their cost information. That’s why pratter has been collecting cost information from self-insured employers to round out its data, Hennessey said.
Self-insured companies request the data on pratter’s behalf, and in return, pratter gives companies a free health care cost analysis, including their return on investment and their top 10 costs by total expense and by frequency.
“Every hospital and insurance company to date has been an obstacle. Our workarounds, often, are self-insured employers, whether they’re private or not,” he said. “If you’re a self-insured employer, that bill you get is yours ... and now they know, to the dollar, the cost they’re paying for every item of medical care.”
Pratter has partnered with select health insurance brokers, Hennessey said, and is in the process of talking with community hospitals, which tend to lose business to larger hospitals that tend to charge more for care.
“What we’ve told the community hospitals is give us fair, packaged pricing for common outpatient care. No hidden fees,” Hennessey said. “Include anesthesia, gastroenterology and your medical facility fee all in your maximum final out-of-pocket.”
Family health insurance premiums have grown nearly 400 percent in the last two decades, according to the Henry J. Kaiser Foundation’s Health Research and Education Trust.
By contrast, the average single-family income has increased from $42,900 in 1995 to $54,462 in 2015, according to the U.S. Census Bureau — a growth rate of about 27 percent, not accounting for inflation.
“It’s a $3.3 trillion industry, and the only one with hidden costs before the time of purchase. It’s unacceptable,” he said. “There’s more than 5,000 hospitals in the country, and if we can get on board and befriend the community hospitals like we plan on doing, we’re going to be creating that capitalistic, competitive environment that exists in every other aspect of consumerism.”
To learn more about pratter or to compare outpatient procedure costs, visit www.pratter.us.