71–80 of 229 posts
Can you tell us about the technology under the hood? Ruby or Node (or whatever)? What APIs did you use? Programming-wise, what was easy and what turned out to be tricky?
Earlier quoted context omitted.
Can I ask why you're spending thousands of dollars on Rx and care? From what I've gathered Medicaid patients have co-pays of $3-$5 on drugs and very small office visit co-pays. I'm not questioning your story, just genuinely curious what the extra costs are.
Not a problem My mother is covered by Indiana's medicaid program, as she's at the poverty level but not old enough yet to qualify for Medicare. Her prescription buydown/deductible every month is $550, which I pay for. If you don't mind, I don't want to list specific medications, as it might make it easier to determine her identity. She takes medication for bone mineralization, hormone replacement due to a heart condi…
I guess my question is, what if a Medicaid patient in IN was truly destitute? There must be some mechanism for patients who can't afford those types of costs.
Earlier quoted context omitted.
Even with insurance your coinsurance could be up to 20%. So, for complex procedures, it is very useful to see if you can get it done some place cheaper. First example of intracranial hemorrhage, price ranges from $9,540 - $234,913. Certainly gives a lot of input to make an appropriate decision. Very unlikely that without medicare negotiation, prices will magically converge to some middle point for all of them.
The issue is that if you have insurance, you're not paying the charge master rate or the Medicare rate, you're paying the negotiated (and likely non-public) rate for your insurer. The 20% co-insurance you pay is based on the negotiated rate.
For the majority of us _not_ on medicare, castlighthealth.com is solving this. It's B2B for now, i.e. Tesla pays for castlight and then its employees can use castlight to find out how much things will cost.
Many insurance companies have tools that can do this exact thing for their members AND apply it to your specific plan at the time of the inquiry. So you can choose based on the procedure cost and your actual cost based on your deductible and co-insurance. Not only that, the tools will also tell you about quality so you can compare based on the quality of service, cost of service and your actual cost at the same time.
Unless you can do all of these things at the same time with your tool, it leaves out critical factors for those actually searching for this type of information as it applies to them at any given time - most importantly when they are trying to make a decision.
Additionally, you only have access to negotiated rates for Medicare whereas an insurance company providing this information is going to provide as much information as they can for all of their members by displaying their negotiated rates specific to your plan.
As an HN reader, if you like this tool, go check with your insurance company and see what they already have and how specific it is for you.
http://www.cms.gov/icd10manual/fullcode_cms/P0136.html
the link shows all the diagnoses that fall in that category of DRGs. (DRGs are the packages of procedures that Medicare pays a fixed price for, simply put. If you get that diagnosis, you submit that DRG. However in this case the map from diagnosis to DRG is one to many.) Some of the average costs are only from 20-30 discharges. Do you think that makes for good math or some sort of price guide?
https://en.wikipedia.org/wiki/Diagnosis-related_group
It may highlight that the DRG is incorrectly applied by some hospitals (maybe?), but it has nothing to do with 'going down the street' for a better 'price'.
nice interface though.
Bug: (FF 16.0.1 on OSX 10.8.5) When the "select a procedure" drop down box is expanded, wheel scrolling up/down seems to also zoom the map underneath it.
http://www.cms.gov/icd10manual/fullcode_cms/P0136.html
the link shows all the diagnoses that fall in that category of DRGs. (DRGs are the packages of procedures that Medicare pays a fixed price for, simply put. If you get that diagnosis, you submit that DRG. However in this case the map from diagnosis to DRG is one to many. And the reimbursement will vary by DRG.) Some of the average costs are only from 20-30 discharges. Do you think that makes for good math or some sort of price guide?
https://en.wikipedia.org/wiki/Diagnosis-related_group
It may highlight that the DRG is incorrectly applied by some hospitals (maybe?), but it has nothing to do with 'going down the street' for a better 'price'.
nice interface though.
Who cares? My insurance co-pay is the same either way, which is exactly the problem. There is zero incentive to shop on price. Btw, nice work :)
But this tool only includes Medicare data so it doesn't apply to any of those cases we just mentioned.