For the first time in history (in 2013) The Center for Medicare and Medicaid Services released data on medical procedure and treatment costs. This dataset includes millions of rows of data. With a variety of fields to choose from regarding medical providers such as Hospitals, Medical Doctors, Physician Assistants, Chiropractors, Nurse Practioners, Optometrists, Dentists, Podiatrists, Ambulatory Centers, just to name a few. Since, there's been a few updates on these releases over the course of three years.
Implementing healthcare price transparency within itself will not reduce healthcare costs. Though price transparency is critical and part of the equation, other analysis and grouping of relevant data will need be implemented as well. The cost of procedures and treatments need to be justified by using medical provider comprehensive data. Also, a very well structured set of algorithms is essential for ultimately developing a metric system based on relevant factual data.
What does this mean for healthcare consumers?
Consumers will be able to price shop and compare medical and dental procedures or treatments regardless of Insurance type. Also, finding medical providers based on a patients specific medical needs such as costs, volumes, credentials, provider score (scoring metric system). and others will be at our finger tips.
PROCEDURE COST EXAMPLE WITH MEDICARE
Here is an example of an actual cost data comparison in our database. Please keep in mind, though this is Medicare data it's a very good tool to use with your existing insurance provider and there coverages throughout different providers and procedure costs etc. Below (A and B) you have an MRI Scan Brain in Radiology Diagnostic. For the same procedure with the same provider (or group practice) you will see the cost difference of 5X plus (out of your pocket) for one visit. Though the difference is only a few hundred dollars, it's very consistence throughout different medical facilities offering there services. Matter of fact, we have an abundance of cost disparities in the tens of thousands of dollars for the exact same procedures. .
What does "Medicare Allowed Cost" mean?
Medicare Allowed Cost - Is the average of the Medicare allowed amount for service; this figure is the sum of the amount Medicare pays, the deductible and the coinsurance amounts that the beneficiary is responsible for paying, and any amounts that a third party is responsible for paying.
Our healthcare system is heavily regulated with many tentacles making it a very difficult and complex industry to navigate. Though your average healthcare consumer may not see it happening, we're in a healthcare storm and a revolution throughout our healthcare system is being manifested. From healthcare price transparency to telemedicine the sleeping giant has awoken, and rest assured many changes throughout many tentacles are happening.