And I don't think the chargemaster price is even correlated with the final price, so it's not even useful as a relative measure.
I wish it was a real price though - maybe this site could push hospitals that way. But I doubt it because the reason hospitals are able to afford Medicare prices is only because they overcharge the rest, and the prices are made opaque specifically so that that people do not complain about that.
The only way to make transparent healthcare prices is to raise medicare prices so that everyone pays the same, but that'll never happen. So what happens is that insured people pay an extra premium to help out the rest.
Airlines do the same thing, and they too have very convoluted hard to understand prices.
That's simply not true. Medicare prices are explicitly designed to cover costs, based off of collected data and input from the self-interested American Medical Association[1]. They almost carte blanche accept the AMA at their word, and I doubt the doctors at the AMA are shooting themselves in the foot (although they appear to be backstabbing under-represented GPs). What Medicare doesn't do is pay excessively, so poorly ran facilities may go red. One of the motivations behind incentivizing (and soon requiring) electronic health records is the ability it gives Medicare to objectively analyze this information, rather than taking the doctor's subjective assessment.
What does inflate private insurance rates is unnecessary market saturation, where hospitals are expanding to capture patients from competitors and lowering per-hospital utilization in the process. Particularly an issue with non-profits, which have little other recourse to spend their profits on except higher salaries and facility expansion. The other main reason for higher insurance rates is bad debt, which is the percentage of care hospitals write-off because they don't expect to recoup the charges[2]. Since Medicare payments are supposedly break even, this is almost solely absorbed by private insurance. That's one of the reasons hospitals are for Obamacare, because there will be fewer uninsured and hence less write offs; yet, current reimbursement contracts account for that bad debt already, so they're going to get a lovely profit boost until the payors correct the imbalance.
Anecdotely, revenue cycle departments (that collect payments) love Medicare, because it just pays. Private insurers dispute everything and threaten to pass the bill directly to patients, which the hospital knows will never get paid because the member expects their insurance to take care of it.
[1] http://www.washingtonpost.com/business/economy/how-a-secreti...
[2] http://www.acainternational.org/products-health-care-collect...
It's not just Medicare. It's insurance in general, and the arms race to try to get paid the same amount (adjusted for inflation) for the same procedure, over time.
So, suppose you get a really nasty cut that needs stitches, and you go to a clinic, and get that done. And suppose that the clinic adds up all the costs -- medical supplies, nurse time, doctor time, facilities (which includes everything from rent to keeping the lights on), time to process the bill through your insurance company, everything, and decide that $100 covers it, so they send a bill for $100 for "suturing" (the stitches to close up your cut). Your insurance company pays, everybody's happy.
Fast forward a few years. Little bit of inflation has happened, so maybe now the clinic needs to make $102. But the insurance company has used the leverage of its network system to get the clinic to accept a lower rate -- they can threaten to stop sending patients to the clinic if the clinic won't agree. And now the "suturing" billing code only pays $90.
So some clever person at the clinic comes up with an idea: instead of billing "suturing" for $102 and getting $90, they can bill for "antiseptic gel" at $20 and get paid $12, and bill for "suturing" at $100 and get paid $90, which means the clinic gets the $102, but now on a total bill of $120.
Fast forward a few more years. Now inflation has resulted in the clinic needing to make $105, but the insurance pays even less now. So now it's billed as "suturing" at $100 (paying $80), plus "antiseptic gel" at $20 (paying $8), plus "cotton swabs" (to soak up the blood) at $30 (paying $17). The clinic gets the $105 to cover its costs, but now the initial bill comes in at $150.
It does not take a terribly long time for this arms race to turn treatment of a simple cut into a gigantic laundry list of services, materials, personnel and facilities, at a total initial bill that might run into the thousands of dollars, just to get, say, $110 out of the insurance company.
And that is basically what has been happening in the US. When you see one of those "shocking" hospital bills for something that seems simple, what you're seeing is the result of the arms race between the medical billing arm of the hospital and the insurance company, which will have dozens or possibly hundreds of items on the bill, all at prices well above what the hospital expects to get, but calculated so that the eventual insurance payment will cover the actual cost.
We've also indexed the Medicare DRGs which are a more accurate predictor. Eventually we'd like to index Paid Claims data for insurance companies, which are what actually gets paid.
The prices are all over the map in general, beyond just the chargemaster prices.
But since many actual prices are determined as a percentage of the chargemaster, the provider with the lowest chargemaster price is likely to have the lowest actual price.
Directionally correct data is better than no data? no?
[1] http://www.nytimes.com/2013/05/17/business/bayonne-medical-c...
Huge swaths of "money" in the medical industry are the result of paper pushing, pure and simple. No one is spending their own money, or even really "real" money: the doctor's bill will say something outrageous for the cash price, because they know the insurers will demand a large reduction, and even though they write "$40,000" for something, they don't actually expect anyone to pay that directly. They expect you to either call and get a "cash payment discount", i.e., something close to what they charge insurance companies (which is still really high, because insurance companies aren't spending "real" money either), or to use your insurer to "pay" the bill.
Remove the lecherous middle-men who do nothing but shuffle numbers around and we can start making progress on medical pricing. This is not the ONLY cause of high costs, but it is easily the largest and most perverse problem point, because this type of billing completely destroys all conventional rules of supply and demand.
Interestingly, the Affordable Care Act does the opposite of this, and strengthens the lecherous middle-men to the point that it will be illegal not to give them money (the government will forcibly take the money from you in the form of a "tax penalty" if you do not voluntary sign up for "medical insurance").
So, the people that need to use it are always going to be a small group. The people that don't have it, another group. The people getting screwed (on the sharp end) are the subset of those where there is overlap. This will always be a small number (by math).
That being said, for everyone is paying into the system but its more death by thousand cuts. As long as pricing is opaque and uncorrleated with out-of-pocket marginal payments, there will be a problem. The cleaner solution is simply to remove the facade of pricing a-la-carte services.
The problem there, is two fold: (1) how to control the inevitable buracracy with a huge budget making life or death decisions; and (2) how to incentivise research and science/product development without the cash cow of monopoly pricing (patents are useless if selling is illegal).
While these problems seem to be solvable, they are daunting and not simple. In a world where the NSA is spying on every electronic communication over the internet, perhaps even more so. Ie, a world where privacy and trust is being undermined by those seeking to entrench their own power. Its harder poltically to delegate more responsibility to the "government".
That guy was on a mission, and his mission wasn't to improve public health. If his mission was that he would have listed the other important metrics. He knows all about them, he is a physician, after all. This sort of dishonesty I cannot stand.
Some other links to more info are at the footer of the page. There was an interesting US Senate hearing with Steven Brill, the author of the Time article.
To really make buying decisions for your own health care procedures, you would want user reviews in addition to prices, just like you see on every online storefront.
outside of California, the data from a release by Medicare: http://www.cms.gov/Research-Statistics-Data-and-Systems/Stat...
Who will be the primary users of this information? It seems that insurers already are aware of chargemaster prices and ignore them since they're going to be bargained away.
Employers seem not to care to dig into how much their insurers are paying (employers just care what premium they'll have to pay).
Finally, it seems like consumers can't really use this data since they're pretty much locked into their plans anyways and will go wherever is most convenient.
Now given changing consumer behavior, I could see consumers maybe using this so they have to pay less of a deductible, I could also see insurers working with consumers to steer them to the best prices - saving both the insurer and the consumer money. However, this will require overcoming consumer attachments to preferred providers (a challenge for older adults, not so much so for younger ones who often don't have a relationship with a doctor). It can be how surprising how quickly people can overcome sentimental attachments when their money is on the line though, so who knows.
If there's some unstructured data that you're having trouble taming, contact me. I have a ton of experience with Mechanhcal Turk and can give you some advice on how best to structure your HITs to extract the data that you need.
jim.jones1@gmail.com
At the top of the page, the search boxes are mis-aligned to the text above them. Fix that. They could also take up more horizontal space, or simply be aligned better.
Add an extra ~3-10px of horizontal padding to table cells (td's) Table headings should be text-align: center except for the longest field (hospital). Also, vertical-align: middle on table headings.
Link color on the tables could also be darker.
Add left-margin/padding on the (?) question mark icon at the top right of fields.
Font size on the search drop downs could be bigger.
May want to try the font "Open Sans", too, on the tables.
Add a hover effect for all links and buttons. It's kind of nuts that you could overlook that.
Add a focus effect for all inputs. Also make input font color brighter, and on focus, make font color darker.
On the "worst hospitals" table, the percentages could use a + sign before them like "+97%".
One thing - the google map always sets California as the state, even when I look at hospitals in other states.
