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Comparison shopping for health care - Want to know how much insurers pay for procedures at different hospitals? Check the Virginia Health Information Web site.
Getting a colonoscopy at a freestanding surgery center instead of a hospital outpatient department can shave $371 off the price.
How much private health plans in Virginia pay providers for doing colon-cancer screenings and 30 other medical procedures can vary five-fold or more depending on location of the service. The numbers are available on the Virginia Health Information Web site in a new section on price transparency.
"How much you pay may depend on the doctor, hospital or provider you choose," said Michael Lundberg, executive director of Virginia Health Information, a nonprofit agency contracted by the state to collect and report consumer health data.
For instance, private insurers paid providers $452 on average for a colonoscopy done in a doctor's office, $669 when done in an outpatient surgery center and $1,040 when done as a hospital outpatient procedure.
"In all fairness, hospitals have different requirements on safety," said Lundberg, explaining some of the difference.
The price figures are based on information from eight health insurance companies. The prices are the average "allowed amount," which is usually discounted from full charges.
The figures, Lundberg said, may be useful to people who don't have health insurance or who are enrolled in high-deductible health plans where they may be responsible for more out-of-pocket costs initially.
Individuals may not be able to negotiate the same discounts group health plans get. But having more cost information available can spur competition, which can have the effect of lowering prices, said Del. John M. O'Bannon III, R-Henrico, sponsor of the 2008 legislation to have the data collected and reported.
"I think it's essential that people know what things really cost in health care," said O'Bannon, a physician. "I realize this is just the first step."
He would like to have regional information available instead of just statewide averages.
Medicare, for instance, makes price data available down to the county level for some outpatient procedures.
O'Bannon said higher hospital costs also may reflect cost shifting -- charging higher fees to make up for providing free care to people who can't pay.
Some of the other procedures listed in the price data include arthroscopic knee surgery, breast biopsy, laparoscopic gallbladder surgery, kidney-stone removal and nonmaternity ultrasound.
The report also lists what Medicare, the government health plan for the elderly, reimburses providers.
Because the cost information is based on statewide averages, it will not tell users what a specific health plan paid providers.
Also available on the Virginia Health Information Web site is updated data on health-maintenance organizations. That data show HMOs in Virginia scoring high on quality measures such as whether pregnant patients get care during the first trimester and whether patients with diabetes and heart disease get recommended care.
Contact Tammie Smith at (804) 649-6572 or TLsmith@timesdispatch.com.
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