Hacker News Reader

Comment by kylec | Hacker News Reader

Now that this information is public, I'm looking forward to the startups that will aggregate this info and let you cross-shop hospitals to get the lowest price, like for flights

View on HN

There are several companies that aggregate this data -- the industry term is "Cost Transparency". Amino, Castlight, Healthcare Bluebook, Change Healthcare, Vitals are all players in Cost Transparency.

I bet if you logged into your health insurance portal you'd find a cost transparency tool that could give you a reasonable estimate of what a common procedure would cost.

The unfortunate truth is price doesn't really matter.

1 - Insurers have negotiated rates with providers. They don't want that information shared.

2 - There aren't that many "shoppable" procedures. Shoppable = you're going to make a conscious decision to find the best possible price. Most common were major, non-emergency surgeries like hip or knee replacements or small stuff like imaging. Once you're in the actual care "flow", its highly unlikely to tell the doctor "how much will that MRI cost me? Let me check this app to drive across town and save $20."

3 - For all the talk about consumer demand for cost transparency, Cost is low on the list when it comes to determining if/where to get care. Quality, Availability (accepting new patients, how soon can they see me), Word of Mouth (friend/family recommended), matter more. Largely because....

4 - After a certain point (i.e. once I've hit my deductible) consumers don't care about cost as long as they're in-network.

(former PM of cost transparency application)

I somewhat disagree about #2: you can (and I have) ask your doctor to get an MRI or X-ray from a standalone imaging center rather than a hospital. That alone can shave about 60% off your bill. The "but only somewhat" part is that if your doctor really prefers a certain imaging provider, they may steer you in that direction. Ultimately, though, it's your call.

Disclosure: I work at Amino, but I'm speaking from personal experience and not for them.

I’d rather see a Glassdoor-like portal where you can see what people really paid for billed services directly or via insurance vis a vis the “list price”. That’d be helpful to advise folks who might be negotiating a medical bill to know what payment is likely to be accepted.

What's stopping you from building it? I was also interested in this but wanted to wait until this data became available. Could probbably OCR out people's names pretty quick as well to privacy for them and make em feel better.

Nothing stopping me from building it but hours in the day :)

Would love to do it actually

Not sure how that will be helpful if you are in the middle of a heart attack though.

It will by means of fostering competition.

True, but emergency care is a much smaller portion of medical spending than many people realize: https://www.politifact.com/truth-o-meter/statements/2013/oct...

That's emergency room care, but it's not like you're going to be shopping for care for most care provided in admissions from ER either (especially, e.g., ER -> ICU admissions.)

Still useful for other non-emergency cases. And also, you could pre-choose the hospital when you're healthy!

Maybe if the apps get good enough you just hit a button and it auto calls the cheapest hospital after a bidding war :)

Shopping this way doesn't make sense though since these are list prices. How much they knock off the price for your insurance company or for the uninsured customer is necessary to shop intelligently.

Edited to add: Plus, reality is you can't really know until you get all the bills. How are they going to code the million different things they have to choose between?

I took my son to prompt care once because he had split the webbing between two of his toes and it looked to me like it needed stitches. The doc swabbed it clean and said he couldn't stitch it. He put some superglue on it and sent us home. Paying on the way out they wanted like $450. I said no. They called the manager and told him I wanted a payment plan. I said, no I don't. I want a reasonable bill. He told them to recode it. They said they had looked for a different code and couldn't find one. They looked again. They had a coworker look again. Eventually they recoded from a laceration to a cut or something like that. Dropped the price to $120ish.

(The superglue came off in less than 24 hours.)

Reply on news.ycombinator.com