Impatient | Helping make the health care system work for you
Health

Bargain hunt for health care procedures, but use caution



stethoscope lying on keyboard of a laptop
stethoscope lying on keyboard of a laptop
jfcherry via Flickr Creative Commons

Shopping for things like hotel reservations is pretty easy these days.

There are a lot of websites that allow you to compare options by price and other factors. Some sites – like Priceline - even let you do the online version of haggling: You name the price you're willing to pay and the site matches you with a hotel willing to accept your bid.

Some entrepreneurs are now trying to adapt this approach to the health care field, where it's been notoriously difficult to shop around. It's a development that's being welcomed – with some caution – by people who advocate for transparency in the health care marketplace.

"This approach is the type of thing that the health care market needs," says Dr. Peter Ubel, a professor at Duke University. "With more and more people in the U.S. paying more and more out of pocket for their health care, they need to be more like regular consumers, where they're looking around for price and quality."

Overall, these new sites that bill themselves as being like Priceline for health care "give consumers more power," Ubel says. But, he and others warn, with more power comes more responsibility on the part of the consumer.

A win-win?

Take the Los Angeles-based start-up company ZendyHealth.

The site allows you to choose a procedure from a list of medical services, like CT or MRI scans. It will tell you the average price for that procedure. You can then suggest the price that you're willing to pay, and providers can choose whether to accept the bid. If you undergo the procedure, you can either pay in cash or use funds from your health savings account, if you have a high-deductible health plan.

Another site, MediBid, lets you post a request for a procedure. Doctors and facilities can then bid on your request.

Dr. Vish Banthia, with more than 10 years of experience in head and neck surgery, as well as facial, plastic and reconstructive surgery, is ZendyHealth's chief medical officer. He says he developed the site in response to two problems he'd repeatedly witnessed: Patients were sometimes skipping recommended tests or treatments because they couldn't afford them. Meanwhile, he says, providers were facing the high costs of staying in business.

ZendyHealth, then, is a win-win for patients and providers, he says: Patients can get a deal on certain procedures and providers can try to fill their appointment slots.

"A patient can't input a ridiculously low amount, and of course providers have the right to not accept these prices if it doesn't make sense for them," Banthia says. But "for most of the requests that are being made by the customers on our site, we're able to fulfill them because it makes sense for the provider to accept."

Comparison shopping

The experts I spoke with for this story agree that consumers should be cautious when using these types of tools to shop for health care. In fact, they say, there are several steps consumers should take before using one of these sites.

Say your doctor is recommending you get an MRI scan. First, experts say, it's worth finding out how much the procedure should cost in your area.

If you have insurance, start by checking with your insurance company how much the procedure would cost if you went through your plan. It's also a good idea to check sites like Healthcare Bluebook, which estimate the price of procedures in your area, or KPCC's PriceCheck, which shows the range of prices charged by facilities in your area, what patients have paid and what insurers have covered.

After doing that research, you could check out sites like ZendyHealth or MediBid to see if they offer deeper discounts.

"If it really looks like from one of these sites that the deal might be better, then you might be able to go in with eyes wider open," says Suzanne Delbanco, executive director of Catalyst for Payment Reform, which works on behalf of large employers and other health care purchasers to promote higher-value care in the U.S.

"I would certainly do some comparison shopping before assuming that these sites are offering something better than you might get through the normal means," she adds.

'Price isn't everything'

Experts stress that bargain hunting for medical care is a complex endeavor: When shopping for health care, consumers should not just consider price, but also the quality of the facility, its doctors and the services provided.

"Price isn't everything," Ubel says. "Sometimes you can pay too little for something and end up with something that's very low quality."

So how do you know if that bargain MRI is worth it?

Leah Binder, president and CEO of the Leapfrog Group, recommends doing your due diligence by asking for a facility's infection rates, requesting documentation of its board certification and licensure, and researching other quality measures.

"Try to get some confirmation that this provider is good," Binder says. "That's a very critical element – you're entrusting your health and life to this person, so you need to know that they can do a good job for you."

On its website, ZendyHealth says it has a Medical Advisory Board that screens for top class, highly rated, certified providers and selectively adds them to its provider network.

Binder still has concerns about who might end up being listed on these types of sites.

"We don't know who is going to put their services out into a market like this - it could be some fraudulent providers, it could be some very bad providers who can't get business elsewhere, so we certainly have to be afraid of that," Binder says.

"On the other hand, I'm hopeful that it's a sign that we're going to change the way consumers access health care," she says. "As soon as consumers are out there looking at both price and quality and making deliberate decisions about providers based on those things, we will change the way health care is delivered. It will change everything."

Banthia of ZendyHealth points out that his company isn't trying to encourage people to shop around for cheaper prices for care, "we're just simply taking the entire process of what's been going on between patients and providers and making it more efficient."

Have you tried negotiating the cost of your health care? Tell us about your experience in the comments section below or email us at Impatient@scpr.org.