This is fantastic, clear, concise, and helpful, with a simple UI.
Thanks! The goal was to shed some light on price discrepancies within the US, and not just the US vs other countries.
Show HN: I mapped US medical prices. Save thousands by driving a few miles
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Re: Show HN: I mapped US medical prices. Save thousands by driving a few miles
#42Earlier quoted context omitted.
Is there evidence of correlation?
The next step would be to bring in death/complication statistics by hospital and ratings by surgeon
CMS is actually doing that already (at least for hospitals).
Early next year, CMS will post healthcare quality metrics that it's collected from providers who bill to CMS. In 2015, hospitals will start getting reimbursed based on quality, which is a step in the right direction, however, it is chocked with problems (i.e. treating the best patients will advantage a hospital)
Re: Show HN: I mapped US medical prices. Save thousands by driving a few miles
#43Earlier 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.
Exactly. If this knew what my insurance company had negotiated for the procedure, and I could input my policy details to figure out what my personal cost would be then I can totally see the usefulness. But as a consumer I just have no idea at all what knowing the Medicare reimbursement prices tells me.
If I assume that the relative differences that Medicare has negotiated are similar to the relative differences my insurance company has negotiated (which I'm guessing is an invalid assumption), and if I accurately know what my policy will cover vs not cover (again, a nearly impossible thing to know given how complicated these things are), then maybe you can make a decision with this data. But the system is so complicated that I don't think that works at all by just using this dataset.
Re: Show HN: I mapped US medical prices. Save thousands by driving a few miles
#44Saw this couple of weeks ago http://pricemaps.betterdoctor.com/
Interesting. The prices listed by this tool are very different from the prices listed in the tool in this Show HN post. I wonder how their data differ?
Hi!
I went back and checked the data. If you search for chest pain, and look at Cedar-Sinai Medical Center around Santa Monica,
we are showing this piece of information.
313 - CHEST PAIN,50625,CEDARS-SINAI MEDICAL CENTER,8700 BEVERLY BLVD,LOS ANGELES,CA,90048,CA - Los Angeles,229,43714.62445,5094.71179
In the PriceMaps we made, we are showing the last value, which is the 'Average Total Payments' for the operation.
Not exactly sure if the site mentioned in the HN is using the same data.
Re: Show HN: I mapped US medical prices. Save thousands by driving a few miles
#45Earlier 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.
Your point is a good one, but maybe a different procedure would be a better example- most people suffering from an intracranial hemorrhage aren't in a position to do a whole of of comparison shopping on where to have it taken care of.
I get your point, but people seem to have the ability to shop on quality!
Let's say you suddenly lose your ability to speak, you think it's a stroke, so you head to the closest clinic. They freak out because you need to go to a stroke center. People (or their family) often ask "What's the best stroke center around here? I want to go there!".
If they had the info available to them, why couldn't they include cost in that equation?
Re: Show HN: I mapped US medical prices. Save thousands by driving a few miles
#46This has enormous impact by bringing transparency to medical procedure pricing. One could quite literally save $10-50K by opting to do a procedure just a few miles away. Nice work. Where did you get the data for this? Is it publicly available?
Thanks. Yeah, a lot of people travel abroad to save money, but its possible to find comparable prices nearby too. Patients aren't trained to shop around with procedures though. The Obama Administration has tried to make pricing more transparent--this particular data set is publicly available. Here it is: https://www.cms.gov/Research-Statistics-Data-and-Systems/Sta...
As someone with a disabled mother on medicaid (whom I spend tens of thousands of dollars a year on for prescriptions and care), thank you.
Re: Show HN: I mapped US medical prices. Save thousands by driving a few miles
#47Saw this couple of weeks ago http://pricemaps.betterdoctor.com/
Thanks for the link--haven't seen this. I think they use a different data set for the procedure prices, but I like how they also compare it to a quality ranking. I will look more into how US News quantified hospital scores. What I think matters most for healthcare is not just price, but quality/cost. Quality is difficult to measure, but should factor in recovery speed, number of repeat-procedures, service, etc.
Thanks!
I think, when are showing some numbers, it looks much more perceivable when you have something to compare to, in our case, the top hospitals ranking from the US News.
Some more work will mostly likely be done soon to enrich the data we are showing.
Re: Show HN: I mapped US medical prices. Save thousands by driving a few miles
#48Would it be useful to have a 'show me the cheapest' button? The range in cost hints at the massive variance. The US is crazy. How does a procedure costing 4k in one place cost 120k in another?
Thanks for the feedback. My next goal is to look more into why the price varies so much. The price spread is pretty crazy. Some hospitals have higher fixed costs or salaries depending on the geography. Also, if a hospital is more research-oriented, R&D funds are normally tacked onto the price (one of the reasons why Stanford's Hospital is really expensive). It's hard to find quantifiable data on the breakdown of bill…
The cost adjustments you're talking about are MS-DRG adjustments (the amount the hospital actually gets paid by CMS). From what I can gather, the numbers on the website, are cost numbers, i.e. what the hospital tells CMS it costs them (which is a number they are free to make whatever).
If you want to know why costs vary so much, starting looking at reimbursement. Hospitals are incentivized to raise their list prices because many of them are paid a set percentage.
Re: Show HN: I mapped US medical prices. Save thousands by driving a few miles
#49Earlier 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.
Your point is a good one, but maybe a different procedure would be a better example- most people suffering from an intracranial hemorrhage aren't in a position to do a whole of of comparison shopping on where to have it taken care of.
friend got a 2nd degree burn yesterday. she waited 2h to decide if she went to a hospital because she was out of insurance... so yeah, i think she would have used this site :)
Re: Show HN: I mapped US medical prices. Save thousands by driving a few miles
#50We did a similar thing at BetterDoctor a few weeks ago: http://pricemaps.betterdoctor.com/
Cool! Did you get the data from: http://health.usnews.com/best-hospitals/rankings
I'd love to talk more about how this can be taken to the next step. Can't find your contact info in your profile--mind pinging me at: neilsharma101 at gmail dot com