Helping make the health care system work for you

Your mammogram's hefty price tag, explained

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Valley Breast Care and Women's Health Center in Van Nuys charges its privately insured patients $540 for a basic mammogram.

As part of #PriceCheck, we're trying to bring greater transparency to medical costs by asking you to tell us how much certain medical procedures cost. We received a number of responses to our request for mammogram prices.

We found that across the Los Angeles area, mammograms come with large price tags: Valley Breast Care and Women's Health Center in Van Nuys charges its privately insured patients $540 for a basic mammogram. At Cedars-Sinai Medical Center in Los Angeles, near Beverly Hills, the charged price is $519.

Charges 'don't make sense'

But Edward Prunchunas, the chief financial office at Cedars-Sinai, says these high sticker prices "really don’t make any sense." These charges are really just a starting point to negotiate discounts, he says.

"There's hardly anybody that gets anywhere near charges as payment from any insurer," says Prunchunas.

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Cost transparency reduces price of MRIs, says study

Doctors Fees

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In a recent study, people were informed of price differences among similar-quality MRI facilities, and given the option of selecting lower-price facilities.

A new study in Health Affairs underscores why we've undertaken #PriceCheck, our collaboration with KQED in San Francisco and ClearHealthCosts.com, focusing on health cost transparency.

The study included more than 60,000 Blue Cross and Blue Shield members, whose employers participated in a price transparency program. People in the study were informed of price differences among similar-quality MRI facilities, and given the option of selecting lower-price facilities.

The authors write:

"As a result, the price transparency program greatly reduced the average price level, shifted patients away from hospital-based facilities, and reduced the price variation between hospital and non-hospital facilities in the intervention group."

They say that the benefits of the transparency project spilled over onto those not involved in the study, noting that people not included in the study saw an average decrease of $57 per test, compared with a $99 decrease in the employer groups participating in the study.

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Prior authorization: Valuable cost-saver or bureaucratic black hole?

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Thousands of requests for prior authorization of prescriptions arrive daily in doctors' offices across the country, Danielle Ofri writes.

Last month we heard from an Impatient reader who won a battle with his health insurer over its refusal to authorize a particular medication. But consumers aren't the only ones who find themselves yelling into the phone at a service rep -- your doctor most likely spends time doing it on his or her patients' behalf. 

In an op-ed in the New York Times, Dr. Danielle Ofri, an associate professor at New York University School of Medicine, writes that thousands of letters requesting a doctor's prior authorization for medication arrive daily in medical offices across the country.

She explains that insurance companies require prior authorization as a cost-saving measure: Doctors must provide a compelling reason why their patients need more expensive treatments, rather than less costly medications. She writes:

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Are some veterans exaggerating or lying about their PTSD?

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Are some veterans exaggerating or lying about their post-traumatic stress disorder, in a bid to secure benefits from the Veterans Administration?

Reporter Alan Zarembo poses that question in an investigation in the Los Angeles Times. He notes that over the last 13 years, the number of veterans on disability for PTSD has increased from 133,745 to more than 656,000. Depending on the severity of their condition, he writes, veterans can receive up to $3,000 a month, tax free, for PTSD-related disability.

According to Zarembo, a VA psychologist from Florida estimated that about half the veterans he evaluates for PTSD are exaggerating or lying about their symptoms. He quotes Christopher Frueh, a University of Hawaii psychologist with 15 years of experience treating PTSD in the VA system:

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Would you use an app to share your STD test results?

STD Status App - 1

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Zoë Klar, 23, of Los Angeles has used both Tinder and OkCupid for online dating.

Pretend you meet someone you really like – be it at a bar, on a mobile dating app like Tinder, or on an online dating site like OkCupid – and you want to become more intimate with this person.

Do you ask about STD status? If the response is, "oh yeah, I just got tested, I’m good to go," do you ask for proof?

It’s an awkward conversation. But it’s a critical one, especially when an infection like gonorrhea – which has no symptoms – increased 13 percent between 2012 and 2013 in California. Chylamida - which also has no symptoms - decreased slightly during that period, but it’s still the most common STD in the state.

"I'll show you mine"

Today I reported on an app, called Healthvana, that allows users to access their STD test results online or on their phones, and share them with prospective partners, if they choose. The company bills itself as the modern version of, "if you show me yours, I’ll show you mine" for STD test results.

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