Monday, November 16, 2009
Health information for Virginians
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John S. Edwards
Edwards, of Roanoke, is the state senator for the 21st District.
The rising cost of health care is a major driver in the move to reform health care. Less understood, but also a concern, is the pricing of health care procedures by particular health care providers. The wide variance in prices charged for the same procedure from one hospital to another is as inexplicable as it is unknowable beforehand. As Princeton health care economist Uwe Reinhardt has noted, the pricing of hospital procedures is "opaque" to the public.
But now, in Virginia, for the first time, information is available to make the prices actually paid for medical procedures and office visits more transparent. Under legislation I sponsored in 2008 with Del. John O'Bannon, R-Henrico County, a report is now available showing the average amounts that health insurers and Medicare pay in Virginia for 31 standard procedures, including preventive, emergency, outpatient and inpatient hospital care.
This is information a patient can review on what certain health care procedures might cost -- before the patient receives the medical care.
Published by the independent, nonprofit Virginia Health Information, the report gives average amounts paid for procedures from a routine office visit to an MRI, knee surgery or delivering a baby.
This ground-breaking report will help patients and others know beforehand what a procedure may cost.
Among those benefitting from this information are the growing number of people without health insurance who might want to negotiate a lower price than the full charge.
Also, the increasing number of those enrolled in high-deductible health plans might want to shop around for a lower price to reduce the amount of their co-payments for medical tests or surgery.
There are more than 1 million uninsured Virginians and an increasing number of workers enrolled in plans with annual deductibles of $1,000 or more. In fact, 40 percent of workers in small firms with fewer than 200 workers and 13 percent of workers in larger firms are enrolled in plans with high deductibles. They might find useful the information about costs in the report before undergoing a procedure.
To prepare the report, Virginia Health Information collaborated with representatives of health insurance plans, hospitals, physicians and the Virginia Department of Health. The data on average reimbursements for specific health care services and procedures is based on annual surveys. According to Michael Lundberg, VHI's executive director, Virginia is one of the first states to produce such a report.
The report is on the Web and even includes a description of common procedures along with links to expert sources for additional information on the services. A view of the procedures can actually be seen through YouTube.
The VHI Web site also includes other useful information, such as a consumer's guide to hospitals and physicians in Virginia, various health care services and health insurance options as well as Medicare, Medicaid and Medigap programs. The new Obstetrics Care Guide allows consumers to compare physician and hospital obstetric services. Information on long term care in Virginia is also available on the VHI Web site at www.vhi.org.
With this new transparency report, Virginia has become a leader in making health care information available to the public. Virginia's patients now have reliable information to get the greatest value for their health care dollars.
