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Health Care Reform:

Health Insurance & Affordable Care Act

In Mass., Getting Prices in Advance Not Easy

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This is the world in which Collins is supposed to become a savvy health care consumer, making informed decisions about where to get the best care at the best price.

Both Emerson Hospital and UMass Memorial Health Care say they are committed to making prices easily available for patients. A spokeswoman for Emerson says she was dismayed that Collins did not receive a prompt response.

UMass Memorial Health spokesman Robert Brogna says it is “working through some challenges in the early days of the new requirements, and some interactions have clearly been less than optimal. This will change. In the coming weeks we will be providing a phone line and establishing new policies and procedures to support this new requirement.”

“It’s very different from, you go into Best Buy, you want to buy a refrigerator,” says Karen Granoff, the senior director for managed care at the Massachusetts Hospital Association. Granoff says her members are working with insurers to nail down prices that hospitals can quote patients.

“They know they need to do this,” Granoff says. “They are not opposed to the transparency. I think they are worried about the challenge of getting the information to the patient.”

Doctors, Too

Doctors are also now required to give patients the price of anything they need within two days of a patient’s request. Some large physician groups such as Harvard Vanguard have software that can calculate exactly what your expense will be based on the details of your insurance plan. But many doctors, especially those in small practices, aren’t familiar with the requirement. The state has no authority to make physicians participate.

Dr. Ron Dunlap, president of the Massachusetts Medical Society, says giving patients prices is a good idea, “but I think this project is somewhat of an overshoot. It’s just too broad, there are too many different procedures. My thought is that we should focus on the most frequently used expensive procedures and that’s where most of the savings could be achieved.”

There are no plans to revise the pricing requirement. The state’s undersecretary for the Office of Consumer Affairs, Barbara Anthony, says the time has come to put price tags on health care.

Fri, Feb 7 2014

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