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More than one in five Californians with private health insurance reported receiving “surprise” medical bills at least once over the previous two years, according to a \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/05/07/nearly-1-in-4-californians-hit-by-surprise-medical-bills/\" target=\"_blank\">2015 Consumer Reports survey\u003c/a>.\u003c/p>\n\u003cp>Today in Sacramento, consumer advocates will launch a campaign they hope will eliminate such surprises. Legislation introduced last year by Assembly member Rob Bonta, D-Oakland, is back, after falling just three Assembly votes short of passage in 2015.\u003c/p>\n\u003cp>The California Medical Association is fighting Bonta’s bill, and it is busy preparing a plan of its own with a different approach to the problem — one that puts more of the financial onus on insurers and gives doctors a better deal.\u003c/p>\n\u003cp>At issue: the practice at many hospitals and outpatient surgery centers of using doctors not covered by a patient’s insurance plan — specialists such as anesthesiologists, pathologists and radiologists — for procedures that are otherwise covered.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Because health plans typically pay a small fraction of the charges by these “out of network” specialists, consumers get saddled with their bills. And what they charge is often a lot more than what the insurers pay their in-network docs.\u003c/p>\n\u003cp>Under Bonta’s proposal, health plans would pay these specialists more or less what they pay their covered physicians for similar care. The specialists would accept that level of payment and stop sending big bills to patients.\u003c/p>\n\u003cp>The CMA says this plan would put too big a squeeze on doctors’ pocketbooks. Instead, the association wants to set the payments in line with what the doctors charge.\u003c/p>\n\u003cp>Michael Dondero of Long Beach has experienced the unsettling feeling of coming home to a large, unexpected medical bill. He had hernia surgery last year that was pre-approved by his health plan, held in a hospital covered under the plan and performed by a physician who was also part of the covered network.\u003c/p>\n\u003cp>“And yes, it went fantastic,” Dondero said. “I’m feeling a lot better now.”\u003c/p>\n\u003cp>But about a month after the surgery, Dondero received something that didn’t make him feel so good: an unexpected bill for $771. It turned out the anesthesiologist on duty during his procedure was not covered by his insurance.\u003c/p>\n\u003cp>“To me it was a real eye-opener,” Dondero said. “I just assumed an in-network procedure at an in-network hospital would be covered. But you know what happens when we assume.”\u003c/p>\n\u003cp>Dondero appealed to his insurance company, and after a month of back and forth letters and phone calls, he ended up paying a much smaller amount.\u003c/p>\n\u003cp>Both the Bonta bill and the proposal being drafted by the physicians’ association share the goal of ensuring that patients won’t get the kind of unwanted surprise that landed in Dondero’s mailbox.\u003c/p>\n\u003cp>But after that, the plans diverge. Bonta’s plan is more palatable to the health plans than the one being crafted by the medical association, which would claw back the financial advantage for specialist doctors.\u003c/p>\n\u003cp>Many specialists say the benchmark established by Bonta’s bill is far too low, claiming it would cut physician compensation by two-thirds.\u003c/p>\n\u003cp>In Bonta’s plan, physicians who think they were underpaid can appeal through an independent review.\u003c/p>\n\u003cp>Still, the medical association argues that the bill essentially penalizes doctors for insurer networks that are too small to meet the needs of patients. Doctors should not be forced to pick up the slack when health plans don’t have enough specialists to perform the medical services they’ve promised to cover, the association says.\u003c/p>\n\u003cp>Janus Norman, a senior vice president of the CMA, says the Bonta bill would create a disincentive for health plans to negotiate reasonable rates with providers.\u003c/p>\n\u003cp>The crux, Norman said, is whether surprise bills are ultimately the responsibility of the health plans or the doctors who generate them.\u003c/p>\n\u003cp>Bonta said the argument is not that simple, and that he has spent a year trying to find the middle ground between insurers and physicians.\u003c/p>\n\u003cp>“The challenge has always been getting reimbursed appropriately, and that’s where the fight has been,” Bonta said. “It’s not fully within the ambit of plans to determine who’s in the network, and it’s not fully in the ambit of providers to determine that.”\u003c/p>\n\u003cp>But one thing is clear, he said: “You can’t punish the patient if they do everything right. They schedule it in advance; it’s in the network. It’s not on the patient to find out which providers that day are in the network or not.”\u003c/p>\n\u003cp>Health Access California, a consumer advocacy group based in Sacramento that is sponsoring the Bonta bill, expects to announce today that the California Labor Federation has signed on as co-sponsor. Anthony Wright, executive director of Health Access, said he hopes this expanded support will help tip the scale in favor of the bill’s passage.\u003c/p>\n\u003cp>Wright argued that physicians bear a substantial share of responsibility for the surprise bill problem, and that they have stood in the way of fixing it. So now they should be willing to work out an arrangement that suits everyone, he said.\u003c/p>\n\u003cp>“We are working to end surprise billing, yet the California Medical Association has delayed and held that process hostage for a year to demand high reimbursement rates for its members,” Wright said. “We’ve put a lot of options on the table, and CMA has rejected all of them.”\u003c/p>\n\u003cp>Norman countered that doctors do want to fix the problem, but that the cause of it is the increasingly restricted choice of providers offered by health plans.\u003c/p>\n\u003cp>The medical association’s plan to get higher rates for doctors, based on an average of what similar physicians charge, is a method already employed in other states, including New York and Connecticut.\u003c/p>\n\u003cp>Bill Barcellona, chief lobbyist at the California Association of Provider Groups, which represents physicians that negotiate with insurance companies, said the proposal could throw the payment system out of whack, with some physicians receiving rates “200 percent higher” than what they currently get.\u003c/p>\n\u003cp>Bonta said he hopes to negotiate a compromise but won’t tolerate an attempt by the medical association to push its own agenda at the risk of undermining the main objective of eliminating surprise bills for consumers.\u003c/p>\n\u003cp>He said he is prepared to counter the competing proposal from the association, if necessary, by pushing his own bill through quickly — possibly as early as April.\u003c/p>\n\u003cp>“It isn’t my preference to push this over the finish line, but we will do that if we’re pushed,” he said.\u003c/p>\n\u003cp>Dondero said his surprise bill blindsided him a little, but that in retrospect it shouldn’t have. He urged others to contest such bills, like he did.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>“I think usually when other people get that bill, they just pay it,” he said. “But you can fight it. The thing is, you don’t take ‘no’ for an answer the first go-round.”\u003c/p>\n\n","blocks":[],"excerpt":"Legislation fell three votes short last year. New push pits consumer advocates and health plans against major doctors' group.","status":"publish","parent":0,"modified":1458584366,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":36,"wordCount":1273},"headData":{"title":"Renewed Battle To Pass 'Surprise' Medical Bills Legislation | KQED","description":"Legislation fell three votes short last year. New push pits consumer advocates and health plans against major doctors' group.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Renewed Battle To Pass 'Surprise' Medical Bills Legislation","datePublished":"2016-03-21T18:18:40.000Z","dateModified":"2016-03-21T18:19:26.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"162830 http://ww2.kqed.org/stateofhealth/?p=162830","disqusUrl":"https://ww2.kqed.org/stateofhealth/2016/03/21/renewed-battle-to-pass-surprise-medical-bills-legislation/","disqusTitle":"Renewed Battle To Pass 'Surprise' Medical Bills Legislation","nprByline":"David Gorn\u003cbr />\u003ca href=\"http://californiahealthline.org/\">California Healthline\u003c/a>","path":"/stateofhealth/162830/renewed-battle-to-pass-surprise-medical-bills-legislation","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Have you ever gone in for a medical procedure you knew was covered by your health plan, only to be hit weeks later by a large, unexpected bill from a doctor whose name you didn’t even recognize?\u003c/p>\n\u003cp>If so, you’re not alone. More than one in five Californians with private health insurance reported receiving “surprise” medical bills at least once over the previous two years, according to a \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/05/07/nearly-1-in-4-californians-hit-by-surprise-medical-bills/\" target=\"_blank\">2015 Consumer Reports survey\u003c/a>.\u003c/p>\n\u003cp>Today in Sacramento, consumer advocates will launch a campaign they hope will eliminate such surprises. Legislation introduced last year by Assembly member Rob Bonta, D-Oakland, is back, after falling just three Assembly votes short of passage in 2015.\u003c/p>\n\u003cp>The California Medical Association is fighting Bonta’s bill, and it is busy preparing a plan of its own with a different approach to the problem — one that puts more of the financial onus on insurers and gives doctors a better deal.\u003c/p>\n\u003cp>At issue: the practice at many hospitals and outpatient surgery centers of using doctors not covered by a patient’s insurance plan — specialists such as anesthesiologists, pathologists and radiologists — for procedures that are otherwise covered.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Because health plans typically pay a small fraction of the charges by these “out of network” specialists, consumers get saddled with their bills. And what they charge is often a lot more than what the insurers pay their in-network docs.\u003c/p>\n\u003cp>Under Bonta’s proposal, health plans would pay these specialists more or less what they pay their covered physicians for similar care. The specialists would accept that level of payment and stop sending big bills to patients.\u003c/p>\n\u003cp>The CMA says this plan would put too big a squeeze on doctors’ pocketbooks. Instead, the association wants to set the payments in line with what the doctors charge.\u003c/p>\n\u003cp>Michael Dondero of Long Beach has experienced the unsettling feeling of coming home to a large, unexpected medical bill. He had hernia surgery last year that was pre-approved by his health plan, held in a hospital covered under the plan and performed by a physician who was also part of the covered network.\u003c/p>\n\u003cp>“And yes, it went fantastic,” Dondero said. “I’m feeling a lot better now.”\u003c/p>\n\u003cp>But about a month after the surgery, Dondero received something that didn’t make him feel so good: an unexpected bill for $771. It turned out the anesthesiologist on duty during his procedure was not covered by his insurance.\u003c/p>\n\u003cp>“To me it was a real eye-opener,” Dondero said. “I just assumed an in-network procedure at an in-network hospital would be covered. But you know what happens when we assume.”\u003c/p>\n\u003cp>Dondero appealed to his insurance company, and after a month of back and forth letters and phone calls, he ended up paying a much smaller amount.\u003c/p>\n\u003cp>Both the Bonta bill and the proposal being drafted by the physicians’ association share the goal of ensuring that patients won’t get the kind of unwanted surprise that landed in Dondero’s mailbox.\u003c/p>\n\u003cp>But after that, the plans diverge. Bonta’s plan is more palatable to the health plans than the one being crafted by the medical association, which would claw back the financial advantage for specialist doctors.\u003c/p>\n\u003cp>Many specialists say the benchmark established by Bonta’s bill is far too low, claiming it would cut physician compensation by two-thirds.\u003c/p>\n\u003cp>In Bonta’s plan, physicians who think they were underpaid can appeal through an independent review.\u003c/p>\n\u003cp>Still, the medical association argues that the bill essentially penalizes doctors for insurer networks that are too small to meet the needs of patients. Doctors should not be forced to pick up the slack when health plans don’t have enough specialists to perform the medical services they’ve promised to cover, the association says.\u003c/p>\n\u003cp>Janus Norman, a senior vice president of the CMA, says the Bonta bill would create a disincentive for health plans to negotiate reasonable rates with providers.\u003c/p>\n\u003cp>The crux, Norman said, is whether surprise bills are ultimately the responsibility of the health plans or the doctors who generate them.\u003c/p>\n\u003cp>Bonta said the argument is not that simple, and that he has spent a year trying to find the middle ground between insurers and physicians.\u003c/p>\n\u003cp>“The challenge has always been getting reimbursed appropriately, and that’s where the fight has been,” Bonta said. “It’s not fully within the ambit of plans to determine who’s in the network, and it’s not fully in the ambit of providers to determine that.”\u003c/p>\n\u003cp>But one thing is clear, he said: “You can’t punish the patient if they do everything right. They schedule it in advance; it’s in the network. It’s not on the patient to find out which providers that day are in the network or not.”\u003c/p>\n\u003cp>Health Access California, a consumer advocacy group based in Sacramento that is sponsoring the Bonta bill, expects to announce today that the California Labor Federation has signed on as co-sponsor. Anthony Wright, executive director of Health Access, said he hopes this expanded support will help tip the scale in favor of the bill’s passage.\u003c/p>\n\u003cp>Wright argued that physicians bear a substantial share of responsibility for the surprise bill problem, and that they have stood in the way of fixing it. So now they should be willing to work out an arrangement that suits everyone, he said.\u003c/p>\n\u003cp>“We are working to end surprise billing, yet the California Medical Association has delayed and held that process hostage for a year to demand high reimbursement rates for its members,” Wright said. “We’ve put a lot of options on the table, and CMA has rejected all of them.”\u003c/p>\n\u003cp>Norman countered that doctors do want to fix the problem, but that the cause of it is the increasingly restricted choice of providers offered by health plans.\u003c/p>\n\u003cp>The medical association’s plan to get higher rates for doctors, based on an average of what similar physicians charge, is a method already employed in other states, including New York and Connecticut.\u003c/p>\n\u003cp>Bill Barcellona, chief lobbyist at the California Association of Provider Groups, which represents physicians that negotiate with insurance companies, said the proposal could throw the payment system out of whack, with some physicians receiving rates “200 percent higher” than what they currently get.\u003c/p>\n\u003cp>Bonta said he hopes to negotiate a compromise but won’t tolerate an attempt by the medical association to push its own agenda at the risk of undermining the main objective of eliminating surprise bills for consumers.\u003c/p>\n\u003cp>He said he is prepared to counter the competing proposal from the association, if necessary, by pushing his own bill through quickly — possibly as early as April.\u003c/p>\n\u003cp>“It isn’t my preference to push this over the finish line, but we will do that if we’re pushed,” he said.\u003c/p>\n\u003cp>Dondero said his surprise bill blindsided him a little, but that in retrospect it shouldn’t have. He urged others to contest such bills, like he did.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“I think usually when other people get that bill, they just pay it,” he said. “But you can fight it. The thing is, you don’t take ‘no’ for an answer the first go-round.”\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/162830/renewed-battle-to-pass-surprise-medical-bills-legislation","authors":["byline_stateofhealth_162830"],"categories":["stateofhealth_2442","stateofhealth_14"],"tags":["stateofhealth_799","stateofhealth_2519"],"featImg":"stateofhealth_49989","label":"stateofhealth"},"stateofhealth_155806":{"type":"posts","id":"stateofhealth_155806","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"155806","score":null,"sort":[1456946274000]},"guestAuthors":[],"slug":"supreme-court-strikes-at-states-efforts-on-health-care-transparency","title":"Supreme Court Strikes At States' Efforts On Health Care Transparency","publishDate":1456946274,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>The U.S. Supreme Court dealt a \u003ca href=\"http://www.supremecourt.gov/opinions/15pdf/14-181_5426.pdf\" target=\"_blank\">blow Tuesday\u003c/a> to nascent efforts to track the quality and cost of health care, ruling that a 1974 law precludes states from requiring that every health care claim involving their residents be submitted to a massive database.\u003c/p>\n\u003cp>The arguments were arcane, but the effect is clear: We're a long way off from having a true picture of the country's health care spending, especially differences in the way hospitals treat patients and doctors practice medicine.\u003c/p>\n\u003cp>It also means that, for the time being at least, we'll remain heavily reliant on data being released by Medicare, the federal health insurance program for the elderly and disabled, to study variations in health care. ProPublica has used Medicare data to study differences in \u003ca href=\"https://projects.propublica.org/checkup\" target=\"_blank\">medication prescribing\u003c/a>, \u003ca href=\"https://projects.propublica.org/surgeons/\" target=\"_blank\">surgeons' complication rates\u003c/a> and \u003ca href=\"https://projects.propublica.org/treatment/\" target=\"_blank\">use of services by doctors\u003c/a>, but it's still not clear that Medicare is representative of all health care in the country.\u003c/p>\n\u003cp>The court's decision involves a case from Vermont, one of 18 states that created so-called all-payer claims databases. Vermont's law called for health insurers, health providers, medical facilities and government agencies to report data on health care costs, prices, quality and use of services to the state. That included employers who pay the costs of their workers' treatments themselves, and not through an insurance contract. (Self-insurance is common for large companies.)\u003c/p>\n\u003cp>But Liberty Mutual Insurance Co. objected, saying the Employee Retirement Income Security Act of 1974, or ERISA, prevents states from imposing such a requirement on self-funded plans. The idea is that companies that have operations across the country shouldn't be subjected to 50 different state laws, but instead should only have to abide by rules from one agency, namely the U.S. Department of Labor.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The court sided with Liberty Mutual, in a 6-2 decision, ruling it didn't have to submit the data demanded by Vermont.\u003c/p>\n\u003cp>In a friend-of-the-court \u003ca href=\"http://www.scotusblog.com/wp-content/uploads/2015/09/150904-amicus-gobeille-liberty.pdf\" target=\"_blank\">brief filed last September\u003c/a>, the American Hospital Association and the Association of American Medical Colleges said that without the data from self-funded plans, all-payer claims databases will be incomplete and not as valuable as they could be.\u003c/p>\n\u003cp>\"Hospitals only have data for the patients they treat,\" the groups wrote. \"Information from across the spectrum of an individual's health care experience is needed to inform clinical, payment, and public health policy...Complete data across all payers (including self-insurers like Respondent) is required so that both health care providers and policymakers can understand the variations in the health care system, and address those that need to change.\"\u003c/p>\n\u003cp>They also noted that self-insured plans cover a \"large majority of the working population: in 2013, nearly 60 percent of workers with health insurance were enrolled in such plans, and that figure is growing.\"\u003c/p>\n\u003cp>So what now? One option is for self-insured plans like Liberty Mutual to voluntarily provide their data to state-run databases. But given the lawsuit, that appears unlikely.\u003c/p>\n\u003cp>Another possibility, raised by Justice Stephen Breyer, is for the federal government to require self-insured plans to disclose their data. \"I see no reason why the Secretary of Labor could not develop reporting requirements that satisfy the states' needs, including some state-specific requirements, as appropriate,\" he wrote.\u003c/p>\n\u003cp>For now, though, we may have to do what we have done for years: Settle for an incomplete picture of health care spending and utilization.\u003c/p>\n\u003cp>Our team at ProPublica has already found fascinating patterns in Medicare data. In \u003ca href=\"https://www.propublica.org/article/billing-to-the-max-docs-charge-medicare-top-rate-for-office-visits\">one example\u003c/a>, 1,800 doctors billed Medicare for the most expensive type of office visits at least 90 percent of the time, compared to just 4 percent of office visits for all doctors.\u003c/p>\n\u003cp>Another group, the \u003ca href=\"http://www.healthcostinstitute.org/\" target=\"_blank\">Health Care Cost Institute\u003c/a>, has greenlighted research using data from three of the nation's largest private insurance companies. It has found some \u003ca href=\"http://www.healthcostinstitute.org/news-and-events/hcci-releases-new-research-assessing-national-and-state-health-policies\" target=\"_blank\">interesting trends\u003c/a> too, but hasn't released data on individual doctors and hospitals.\u003c/p>\n\u003cp>Medicare could release more data, as could the Health Care Cost Institute.\u003c/p>\n\u003cp>The Supreme Court decision means transparency has a long way to go.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003ca href=\"https://www.propublica.org/about/pixelping\" target=\"_blank\">Charles Ornstein\u003c/a>\u003cem> is a senior reporter at \u003c/em>\u003ca href=\"https://www.propublica.org/\" target=\"_blank\">ProPublica\u003c/a>,\u003cem> an independent investigative newsroom based in New York.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2016 ProPublica. To see more, visit \u003ca>ProPublica\u003c/a>.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Supreme+Court+Strikes+At+States%27+Efforts+On+Health+Care+Transparency&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n","blocks":[],"excerpt":"The U.S. Supreme Court ruled that states can't require many large employers to submit health care claims to a massive database. The decision means Medicare data will remain the go-to source for now.","status":"publish","parent":0,"modified":1456946367,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":19,"wordCount":711},"headData":{"title":"Supreme Court Strikes At States' Efforts On Health Care Transparency | KQED","description":"The U.S. Supreme Court ruled that states can't require many large employers to submit health care claims to a massive database. The decision means Medicare data will remain the go-to source for now.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Supreme Court Strikes At States' Efforts On Health Care Transparency","datePublished":"2016-03-02T19:17:54.000Z","dateModified":"2016-03-02T19:19:27.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"155806 http://ww2.kqed.org/stateofhealth/?p=155806","disqusUrl":"https://ww2.kqed.org/stateofhealth/2016/03/02/supreme-court-strikes-at-states-efforts-on-health-care-transparency/","disqusTitle":"Supreme Court Strikes At States' Efforts On Health Care Transparency","nprImageCredit":"Saul Loeb","nprByline":"Charles Ornstein","nprImageAgency":"AFP/Getty Images","nprStoryId":"468756393","nprApiLink":"http://api.npr.org/query?id=468756393&apiKey=MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004","nprHtmlLink":"http://www.npr.org/sections/health-shots/2016/03/02/468756393/supreme-court-strikes-at-states-efforts-on-health-care-transparency?ft=nprml&f=468756393","nprRetrievedStory":"1","nprPubDate":"Wed, 02 Mar 2016 08:49:00 -0500","nprStoryDate":"Wed, 02 Mar 2016 08:49:48 -0500","nprLastModifiedDate":"Wed, 02 Mar 2016 08:49:48 -0500","path":"/stateofhealth/155806/supreme-court-strikes-at-states-efforts-on-health-care-transparency","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>The U.S. Supreme Court dealt a \u003ca href=\"http://www.supremecourt.gov/opinions/15pdf/14-181_5426.pdf\" target=\"_blank\">blow Tuesday\u003c/a> to nascent efforts to track the quality and cost of health care, ruling that a 1974 law precludes states from requiring that every health care claim involving their residents be submitted to a massive database.\u003c/p>\n\u003cp>The arguments were arcane, but the effect is clear: We're a long way off from having a true picture of the country's health care spending, especially differences in the way hospitals treat patients and doctors practice medicine.\u003c/p>\n\u003cp>It also means that, for the time being at least, we'll remain heavily reliant on data being released by Medicare, the federal health insurance program for the elderly and disabled, to study variations in health care. ProPublica has used Medicare data to study differences in \u003ca href=\"https://projects.propublica.org/checkup\" target=\"_blank\">medication prescribing\u003c/a>, \u003ca href=\"https://projects.propublica.org/surgeons/\" target=\"_blank\">surgeons' complication rates\u003c/a> and \u003ca href=\"https://projects.propublica.org/treatment/\" target=\"_blank\">use of services by doctors\u003c/a>, but it's still not clear that Medicare is representative of all health care in the country.\u003c/p>\n\u003cp>The court's decision involves a case from Vermont, one of 18 states that created so-called all-payer claims databases. Vermont's law called for health insurers, health providers, medical facilities and government agencies to report data on health care costs, prices, quality and use of services to the state. That included employers who pay the costs of their workers' treatments themselves, and not through an insurance contract. (Self-insurance is common for large companies.)\u003c/p>\n\u003cp>But Liberty Mutual Insurance Co. objected, saying the Employee Retirement Income Security Act of 1974, or ERISA, prevents states from imposing such a requirement on self-funded plans. The idea is that companies that have operations across the country shouldn't be subjected to 50 different state laws, but instead should only have to abide by rules from one agency, namely the U.S. Department of Labor.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The court sided with Liberty Mutual, in a 6-2 decision, ruling it didn't have to submit the data demanded by Vermont.\u003c/p>\n\u003cp>In a friend-of-the-court \u003ca href=\"http://www.scotusblog.com/wp-content/uploads/2015/09/150904-amicus-gobeille-liberty.pdf\" target=\"_blank\">brief filed last September\u003c/a>, the American Hospital Association and the Association of American Medical Colleges said that without the data from self-funded plans, all-payer claims databases will be incomplete and not as valuable as they could be.\u003c/p>\n\u003cp>\"Hospitals only have data for the patients they treat,\" the groups wrote. \"Information from across the spectrum of an individual's health care experience is needed to inform clinical, payment, and public health policy...Complete data across all payers (including self-insurers like Respondent) is required so that both health care providers and policymakers can understand the variations in the health care system, and address those that need to change.\"\u003c/p>\n\u003cp>They also noted that self-insured plans cover a \"large majority of the working population: in 2013, nearly 60 percent of workers with health insurance were enrolled in such plans, and that figure is growing.\"\u003c/p>\n\u003cp>So what now? One option is for self-insured plans like Liberty Mutual to voluntarily provide their data to state-run databases. But given the lawsuit, that appears unlikely.\u003c/p>\n\u003cp>Another possibility, raised by Justice Stephen Breyer, is for the federal government to require self-insured plans to disclose their data. \"I see no reason why the Secretary of Labor could not develop reporting requirements that satisfy the states' needs, including some state-specific requirements, as appropriate,\" he wrote.\u003c/p>\n\u003cp>For now, though, we may have to do what we have done for years: Settle for an incomplete picture of health care spending and utilization.\u003c/p>\n\u003cp>Our team at ProPublica has already found fascinating patterns in Medicare data. In \u003ca href=\"https://www.propublica.org/article/billing-to-the-max-docs-charge-medicare-top-rate-for-office-visits\">one example\u003c/a>, 1,800 doctors billed Medicare for the most expensive type of office visits at least 90 percent of the time, compared to just 4 percent of office visits for all doctors.\u003c/p>\n\u003cp>Another group, the \u003ca href=\"http://www.healthcostinstitute.org/\" target=\"_blank\">Health Care Cost Institute\u003c/a>, has greenlighted research using data from three of the nation's largest private insurance companies. It has found some \u003ca href=\"http://www.healthcostinstitute.org/news-and-events/hcci-releases-new-research-assessing-national-and-state-health-policies\" target=\"_blank\">interesting trends\u003c/a> too, but hasn't released data on individual doctors and hospitals.\u003c/p>\n\u003cp>Medicare could release more data, as could the Health Care Cost Institute.\u003c/p>\n\u003cp>The Supreme Court decision means transparency has a long way to go.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003ca href=\"https://www.propublica.org/about/pixelping\" target=\"_blank\">Charles Ornstein\u003c/a>\u003cem> is a senior reporter at \u003c/em>\u003ca href=\"https://www.propublica.org/\" target=\"_blank\">ProPublica\u003c/a>,\u003cem> an independent investigative newsroom based in New York.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2016 ProPublica. To see more, visit \u003ca>ProPublica\u003c/a>.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Supreme+Court+Strikes+At+States%27+Efforts+On+Health+Care+Transparency&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/155806/supreme-court-strikes-at-states-efforts-on-health-care-transparency","authors":["byline_stateofhealth_155806"],"categories":["stateofhealth_2442","stateofhealth_14"],"tags":["stateofhealth_2678","stateofhealth_799"],"featImg":"stateofhealth_155807","label":"stateofhealth"},"stateofhealth_140645":{"type":"posts","id":"stateofhealth_140645","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"140645","score":null,"sort":[1453225399000]},"guestAuthors":[],"slug":"in-kaiser-program-hospital-care-comes-to-the-patients-home","title":"In Kaiser Program, Hospital Care Comes to the Patient's Home","publishDate":1453225399,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{},"content":"\u003cp>Frequent medical visits had become a way of life earlier this year for John and Audrey Stanton.\u003c/p>\n\u003cp>John, 86, suffered from serious eye problems, a painful skin infection called cellulitis and, more recently, repeated shortness of breath — all of which kept landing him in the hospital.\u003c/p>\n\u003cp>\"It was one thing after another. Like the doctor said, 'Somebody is after you!' \" Stanton laughs.\u003c/p>\n\u003cp>And for his 81-year-old wife, Audrey, the nearly two-hour drive each way to Kaiser in Riverside from their home in Hemet was a tough haul.\u003c/p>\n\u003cp>\"I’m not a long-distance driver so I had to be real careful,\" she says. \"It was stressful.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>[soundcloud url=\"https://api.soundcloud.com/tracks/242752789\" params=\"color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\" width=\"100%\" height=\"166\" iframe=\"true\" /]\u003c/p>\n\u003cp>But that stress dissipated last summer when John was admitted to the hospital -- without leaving home.\u003c/p>\n\u003cp>\"I thought, 'Wow! This is amazing. I love this!' \" John Stanton says. \"This is what people need!\"\u003c/p>\n\u003cp>\u003cstrong>Pneumonia, Cellulitis or Congestive Heart Failure\u003c/strong>\u003c/p>\n\u003cp>Stanton is one of about 125 patients who have been enrolled in an experimental \"hospital at home\" program run out of Kaiser’s Permanente’s Riverside Medical Center.\u003c/p>\n\u003cp>Launched two years ago, the program is designed for people who need treatment -- typically only given in the hospital -- for one of three conditions: pneumonia, cellulitis or congestive heart failure.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>\u003ca href=\"http://www.scpr.org/news/2015/11/25/55860/kaiser-program-brings-hospital-care-to-the-patient/\" target=\"_blank\">Read the rest of the story at KPCC.org.\u003c/a>\u003c/em>\u003c/p>\n\n","blocks":[],"excerpt":"Hospital care at home is for patients with certain conditions who are not at risk for complications. ","status":"publish","parent":0,"modified":1453252342,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":14,"wordCount":253},"headData":{"title":"In Kaiser Program, Hospital Care Comes to the Patient's Home | KQED","description":"Hospital care at home is for patients with certain conditions who are not at risk for complications. ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"In Kaiser Program, Hospital Care Comes to the Patient's Home","datePublished":"2016-01-19T17:43:19.000Z","dateModified":"2016-01-20T01:12:22.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"140645 http://ww2.kqed.org/stateofhealth/?p=140645","disqusUrl":"https://ww2.kqed.org/stateofhealth/2016/01/19/in-kaiser-program-hospital-care-comes-to-the-patients-home/","disqusTitle":"In Kaiser Program, Hospital Care Comes to the Patient's Home","source":"KPCC","sourceUrl":"http://www.scpr.org/news/2015/11/25/55860/kaiser-program-brings-hospital-care-to-the-patient/","nprByline":"Stephanie O'Neill/KPCC","path":"/stateofhealth/140645/in-kaiser-program-hospital-care-comes-to-the-patients-home","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Frequent medical visits had become a way of life earlier this year for John and Audrey Stanton.\u003c/p>\n\u003cp>John, 86, suffered from serious eye problems, a painful skin infection called cellulitis and, more recently, repeated shortness of breath — all of which kept landing him in the hospital.\u003c/p>\n\u003cp>\"It was one thing after another. Like the doctor said, 'Somebody is after you!' \" Stanton laughs.\u003c/p>\n\u003cp>And for his 81-year-old wife, Audrey, the nearly two-hour drive each way to Kaiser in Riverside from their home in Hemet was a tough haul.\u003c/p>\n\u003cp>\"I’m not a long-distance driver so I had to be real careful,\" she says. \"It was stressful.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003cdiv class='utils-parseShortcode-shortcodes-__shortcodes__shortcodeWrapper'>\n \u003ciframe width='100%' height='166'\n scrolling='no' frameborder='no'\n src='https://w.soundcloud.com/player/?url=https://api.soundcloud.com/tracks/242752789&visual=true&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false'\n title='https://api.soundcloud.com/tracks/242752789'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\u003cp>But that stress dissipated last summer when John was admitted to the hospital -- without leaving home.\u003c/p>\n\u003cp>\"I thought, 'Wow! This is amazing. I love this!' \" John Stanton says. \"This is what people need!\"\u003c/p>\n\u003cp>\u003cstrong>Pneumonia, Cellulitis or Congestive Heart Failure\u003c/strong>\u003c/p>\n\u003cp>Stanton is one of about 125 patients who have been enrolled in an experimental \"hospital at home\" program run out of Kaiser’s Permanente’s Riverside Medical Center.\u003c/p>\n\u003cp>Launched two years ago, the program is designed for people who need treatment -- typically only given in the hospital -- for one of three conditions: pneumonia, cellulitis or congestive heart failure.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>\u003ca href=\"http://www.scpr.org/news/2015/11/25/55860/kaiser-program-brings-hospital-care-to-the-patient/\" target=\"_blank\">Read the rest of the story at KPCC.org.\u003c/a>\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/140645/in-kaiser-program-hospital-care-comes-to-the-patients-home","authors":["byline_stateofhealth_140645"],"categories":["stateofhealth_11","stateofhealth_13"],"tags":["stateofhealth_799","stateofhealth_803","stateofhealth_2519"],"featImg":"stateofhealth_140646","label":"source_stateofhealth_140645"},"stateofhealth_137669":{"type":"posts","id":"stateofhealth_137669","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"137669","score":null,"sort":[1452585706000]},"guestAuthors":[],"slug":"legislators-trying-again-to-make-drug-costs-transparent","title":"Legislators Trying Again to Make Drug Costs Transparent","publishDate":1452585706,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>With drug manufacturers charging $1,000 a pill for \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/05/21/covered-california-considers-capping-patients-drug-costs/\" target=\"_blank\">hepatitis C treatments\u003c/a> and raising the price of a longstanding \u003ca href=\"http://www.huffingtonpost.com/james-peron/why-one-hiv-drug-costs-5000-percent-more-overnight_b_8174724.html\" target=\"_blank\">HIV medication 5,000 percent\u003c/a>, state lawmakers hope to revive a bill that would demystify prescription drug costs.\u003c/p>\n\u003caside class=\"pullquote align right\">\"Sunlight on costs will help control costs.\"\u003ccite>Assemblyman David Chiu, D-San Francisco\u003c/cite>\u003c/aside>\n\u003cp>\u003ca href=\"https://legiscan.com/CA/sponsors/AB463/2015\" target=\"_blank\">Assembly Bill 463\u003c/a> would require pharmaceutical companies to report production and marketing costs associated with any drug treatment priced at $10,000 or more. The bill, called the Pharmaceutical Cost Transparency Act, was initially\u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520160AB463\" target=\"_blank\"> introduced last February\u003c/a>, but floundered in the Legislature. Now the authors are hoping the growing outcry in the last six months over drug prices will help garner new supporters.\u003c/p>\n\u003cp>“Discontent with drug prices has reached a real breaking point,” said Assemblyman David Chiu, D-San Francisco, author of the bill. “Skyrocketing drug prices are gouging consumers, are costing government billions of dollars, are hitting at the bottom lines of businesses. And this is significantly impacting our health care costs.”\u003c/p>\n\u003cp>Specifically, the bill would require drug makers to report:\u003c/p>\n\u003cul>\n\u003cli>Profits attributed to the drug\u003c/li>\n\u003cli>Costs associated with clinical drug trials, research and development, and manufacturing\u003c/li>\n\u003cli>Government grants that supported research\u003c/li>\n\u003cli>Marketing and advertising\u003c/li>\n\u003c/ul>\n\u003cp>“I think sunlight on costs will help control costs,” Chiu says. “The data that we do know of, suggests that many of these companies are spending billions of dollars marketing and advertising their drugs, and not as much as they suggest on research and development.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Drug makers oppose the bill. They say the time and money spent on the new reporting requirements would be better spent on developing new life saving drugs.\u003c/p>\n\u003cp>“It’s unclear how the bill will actually help patients in the long run,” says Priscilla VanderVeer, spokesperson for the Pharmaceutical Research and Manufacturers of America, a trade group for the industry. “Does it actually lead to lower prices? Once all this information is compiled, then what?”\u003c/p>\n\u003cp>Drug companies are also concerned that some of the information they would have to report is proprietary.\u003c/p>\n\u003cp>“For competitive purposes, the company doesn't want extreme specifics to fall into the hands of their competitors,” VanderVeer says.\u003c/p>\n\u003cp>For example, if companies disclose how much they are spending on a clinical trial, it could signal to a competitor their level of investment in a certain drug or disease, and the competitor might adjust their own practices.\u003c/p>\n\u003cp>Health insurance companies say they have to disclose proprietary information to regulators to justify hikes in premium rates, and they argue the protections for that information are adequate.\u003c/p>\n\u003cp>Health plans have been particularly interested in seeing AB 463 pass. Even though they can negotiate what they pay pharmaceutical companies for drugs to some extent, they're limited in how much of the cost they can pass on directly to consumers. \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520160AB339\" target=\"_blank\">A new law\u003c/a> in California limits how much plans can charge patients out of pocket for specialty drugs to $250 per month, per prescription.\u003c/p>\n\u003cp>\"At the end of the day, we have to buy these drugs,\" says Charles Bacchi, president and CEO of the California Association of Health Plans.\u003c/p>\n\u003cp>Health insurers will have no choice but to raise premium rates for everybody in order to balance the costs, he says.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"When it comes to high priced specialty drugs, the elephant in the room is how much those drugs cost America,\" Bacchi says. \"The pharmaceutical companies want to try to sweep that under the rug, but you can't sweep an elephant under the rug.\"\u003c/p>\n\n","blocks":[],"excerpt":"The bill would require drug makers to disclose production and marketing costs of any drug treatment priced at $10,000 or more.","status":"publish","parent":0,"modified":1452620236,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":17,"wordCount":602},"headData":{"title":"Legislators Trying Again to Make Drug Costs Transparent | KQED","description":"The bill would require drug makers to disclose production and marketing costs of any drug treatment priced at $10,000 or more.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Legislators Trying Again to Make Drug Costs Transparent","datePublished":"2016-01-12T08:01:46.000Z","dateModified":"2016-01-12T17:37:16.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"137669 http://ww2.kqed.org/stateofhealth/?p=137669","disqusUrl":"https://ww2.kqed.org/stateofhealth/2016/01/12/legislators-trying-again-to-make-drug-costs-transparent/","disqusTitle":"Legislators Trying Again to Make Drug Costs Transparent","path":"/stateofhealth/137669/legislators-trying-again-to-make-drug-costs-transparent","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>With drug manufacturers charging $1,000 a pill for \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/05/21/covered-california-considers-capping-patients-drug-costs/\" target=\"_blank\">hepatitis C treatments\u003c/a> and raising the price of a longstanding \u003ca href=\"http://www.huffingtonpost.com/james-peron/why-one-hiv-drug-costs-5000-percent-more-overnight_b_8174724.html\" target=\"_blank\">HIV medication 5,000 percent\u003c/a>, state lawmakers hope to revive a bill that would demystify prescription drug costs.\u003c/p>\n\u003caside class=\"pullquote align right\">\"Sunlight on costs will help control costs.\"\u003ccite>Assemblyman David Chiu, D-San Francisco\u003c/cite>\u003c/aside>\n\u003cp>\u003ca href=\"https://legiscan.com/CA/sponsors/AB463/2015\" target=\"_blank\">Assembly Bill 463\u003c/a> would require pharmaceutical companies to report production and marketing costs associated with any drug treatment priced at $10,000 or more. The bill, called the Pharmaceutical Cost Transparency Act, was initially\u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520160AB463\" target=\"_blank\"> introduced last February\u003c/a>, but floundered in the Legislature. Now the authors are hoping the growing outcry in the last six months over drug prices will help garner new supporters.\u003c/p>\n\u003cp>“Discontent with drug prices has reached a real breaking point,” said Assemblyman David Chiu, D-San Francisco, author of the bill. “Skyrocketing drug prices are gouging consumers, are costing government billions of dollars, are hitting at the bottom lines of businesses. And this is significantly impacting our health care costs.”\u003c/p>\n\u003cp>Specifically, the bill would require drug makers to report:\u003c/p>\n\u003cul>\n\u003cli>Profits attributed to the drug\u003c/li>\n\u003cli>Costs associated with clinical drug trials, research and development, and manufacturing\u003c/li>\n\u003cli>Government grants that supported research\u003c/li>\n\u003cli>Marketing and advertising\u003c/li>\n\u003c/ul>\n\u003cp>“I think sunlight on costs will help control costs,” Chiu says. “The data that we do know of, suggests that many of these companies are spending billions of dollars marketing and advertising their drugs, and not as much as they suggest on research and development.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Drug makers oppose the bill. They say the time and money spent on the new reporting requirements would be better spent on developing new life saving drugs.\u003c/p>\n\u003cp>“It’s unclear how the bill will actually help patients in the long run,” says Priscilla VanderVeer, spokesperson for the Pharmaceutical Research and Manufacturers of America, a trade group for the industry. “Does it actually lead to lower prices? Once all this information is compiled, then what?”\u003c/p>\n\u003cp>Drug companies are also concerned that some of the information they would have to report is proprietary.\u003c/p>\n\u003cp>“For competitive purposes, the company doesn't want extreme specifics to fall into the hands of their competitors,” VanderVeer says.\u003c/p>\n\u003cp>For example, if companies disclose how much they are spending on a clinical trial, it could signal to a competitor their level of investment in a certain drug or disease, and the competitor might adjust their own practices.\u003c/p>\n\u003cp>Health insurance companies say they have to disclose proprietary information to regulators to justify hikes in premium rates, and they argue the protections for that information are adequate.\u003c/p>\n\u003cp>Health plans have been particularly interested in seeing AB 463 pass. Even though they can negotiate what they pay pharmaceutical companies for drugs to some extent, they're limited in how much of the cost they can pass on directly to consumers. \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520160AB339\" target=\"_blank\">A new law\u003c/a> in California limits how much plans can charge patients out of pocket for specialty drugs to $250 per month, per prescription.\u003c/p>\n\u003cp>\"At the end of the day, we have to buy these drugs,\" says Charles Bacchi, president and CEO of the California Association of Health Plans.\u003c/p>\n\u003cp>Health insurers will have no choice but to raise premium rates for everybody in order to balance the costs, he says.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"When it comes to high priced specialty drugs, the elephant in the room is how much those drugs cost America,\" Bacchi says. \"The pharmaceutical companies want to try to sweep that under the rug, but you can't sweep an elephant under the rug.\"\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/137669/legislators-trying-again-to-make-drug-costs-transparent","authors":["3205"],"categories":["stateofhealth_14"],"tags":["stateofhealth_2640","stateofhealth_799","stateofhealth_2519"],"featImg":"stateofhealth_137693","label":"stateofhealth"},"stateofhealth_116325":{"type":"posts","id":"stateofhealth_116325","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"116325","score":null,"sort":[1448918589000]},"guestAuthors":[],"slug":"patients-want-to-price-shop-for-care-but-online-tools-unreliable","title":"Patients Want To Price-Shop For Care, But Online Tools Unreliable","publishDate":1448918589,"format":"standard","headTitle":"Price Check | State of Health | KQED News","labelTerm":{},"content":"\u003cp>Kate and Scott Savett were trying to be responsible when they needed some medical care. They live about an hour north of Philadelphia with their dog, Frankie. Scott, 43, is a chemist and designs software for labs; Kate, 37, works in life insurance.\u003c/p>\n\u003cp>They buy their health insurance through Scott's job, and to keep their premiums affordable, they chose a high-deductible plan. They understood from the beginning that this would mean shopping carefully when they needed care, because costs can vary a lot among doctors and hospitals.\u003c/p>\n\u003cp>For years the couple didn't use their insurance much — but that all changed this year.\u003c/p>\n\u003cfigure id=\"attachment_116326\" class=\"wp-caption alignright\" style=\"max-width: 400px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/11/cost-calculator-1-04d8443fd5934c64fa38d6ff6cbe9a21e21b9101.jpg\">\u003cimg class=\"wp-image-116326 size-thumbnail\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/11/cost-calculator-1-04d8443fd5934c64fa38d6ff6cbe9a21e21b9101-400x300.jpg\" alt=\"Kate and Scott Savett, of Allentown, PA, at an event of the Greater Delaware Valley chapter of the National MS Society, in Philadelphia, PA.\" width=\"400\" height=\"300\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2015/11/cost-calculator-1-04d8443fd5934c64fa38d6ff6cbe9a21e21b9101-400x300.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2015/11/cost-calculator-1-04d8443fd5934c64fa38d6ff6cbe9a21e21b9101-800x600.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2015/11/cost-calculator-1-04d8443fd5934c64fa38d6ff6cbe9a21e21b9101-1440x1080.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2015/11/cost-calculator-1-04d8443fd5934c64fa38d6ff6cbe9a21e21b9101-1180x885.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2015/11/cost-calculator-1-04d8443fd5934c64fa38d6ff6cbe9a21e21b9101-960x720.jpg 960w\" sizes=\"(max-width: 400px) 100vw, 400px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Kate and Scott Savett, of Allentown, Pennsylvania, at an event of the Greater Delaware Valley chapter of the National MS Society, in Philadelphia. \u003ccite>(Bastiaan Slabbers for NPR)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Kate was diagnosed with multiple sclerosis in January. Doctors did a lot of tests and then follow-up tests. On top of that, Scott needed some imaging tests for a spinal issue.\u003c/p>\n\u003cp>Under their insurance plan, the two have to pay in full for the first $3,000 of their combined care. After that, they still have to pay 20 percent of the cost, until they reach a total of $8,000 in out-of-pocket expenses.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>That experience made them want to find the best care for the best deal. But how?\u003c/p>\n\u003cp>They investigated, using an online cost estimator offered through their insurance company.\u003c/p>\n\u003cp>Scott logs in to use the tool, and searches for the typical cost of MRI scans in his region. The online calculator tells him the average cost is $1,270; the lowest is $512 and the \"above average\" is $1,790.\u003c/p>\n\u003cp>The tool then produced a list of different providers and an estimate of how much they will specifically charge under the plan the Savetts have.\u003c/p>\n\u003cp>At first, this kind of information seemed great to the couple. But it quickly proved to be quite the headache.\u003c/p>\n\u003cp>A few days before Kate was scheduled to have her first MRI, she and Scott got a call from the radiology office, saying that the scan would cost them $2,400. They were shocked — the online calculator had told them it would only be about $500.\u003c/p>\n\u003cp>What's the source of the disconnect?\u003c/p>\n\u003cp>A hospital had bought the imaging center and raised the price.\u003c/p>\n\u003cp>[contextly_sidebar id=\"wCEqkhB9BfZ9A3fRaUew9qoV5lT8Q2Dl\"]There were misquotes on other procedures, too. The Savetts received some bills from health providers that were as much as $1,000 higher than the price the online calculator had led them to expect. Another time, they couldn't find any listings at all for a procedure one of them needed.\u003c/p>\n\u003cp>The two quickly plowed through their $3,000 deductible. Financial planning became increasingly difficult. They delayed buying a new water heater for their house.\u003c/p>\n\u003cp>\"It's hard for us to pull the trigger on that, knowing that another bill could be coming around the corner,\" Kate says.\u003c/p>\n\u003cp>It's unclear how common these inaccuracies with online estimators are, but the tools \u003cem>are\u003c/em> becoming more popular, as patients shoulder a bigger share of the cost of their medical care. Outside companies are developing the online calculators, and most insurers offer them.\u003c/p>\n\u003cp>\"Each one of them — whether it's Aetna, United, Cigna — they all have something,\" says \u003ca href=\"http://www.hci3.org/about_hci3/team/francois-de-brantes-ms-mba-executive-director\" target=\"_blank\">Francois de Brantes\u003c/a>, director of the Health Care Incentives Improvement Institute, a nonprofit based in Connecticut. De Brantes has been \u003ca href=\"http://www.catalyzepaymentreform.org/images/Accuracy.pdf\" target=\"_blank\">paying close attention\u003c/a> to price-transparency tools.\u003c/p>\n\u003cp>\"There's lots and lots of variability in the information that's provided to consumers,\" he says.\u003c/p>\n\u003cp>Some of the estimators reflect an aggregate range of possible costs; others are based on historic pricing, or claims data from varying sources. Many, he says, are limited in the type of procedures they include.\u003c/p>\n\u003cp>[contextly_sidebar id=\"zWQnsaE6HJNkAsxDX37CJ1nbtNWIcaEb\"]As for \u003ca href=\"http://www.uhc.com/individual-and-family/why-uhc/programs-tools/myhealthcare-cost-estimator\" target=\"_blank\">United Healthare's cost estimator\u003c/a> — the one the Savetts used — Craig Hankins, the insurer's vice president of consumer engagement products, gives it an 8 out of 10 in terms of accuracy.\u003c/p>\n\u003cp>\"Right now, I would say if we look at our tool, relative to others that are offered, I would say ours is average — if not above average — in terms of breadth of services as well as accuracy,\" Hankins says.\u003c/p>\n\u003cp>UHC's cost calculator is based on current information, he says, adding that it is in the insurer's interest to have the online tool work. If members get care at an acceptable cost, that saves everyone money.\u003c/p>\n\u003cp>But, he says, the tool has limits — it's hard to predict what a particular doctor will actually \u003cem>do\u003c/em> during an exam, treatment, or office visit, and how he or she will bill for it.\u003c/p>\n\u003cp>That gets at a deeper challenge with these online estimators, says David Newman, director of the nonprofit \u003ca href=\"http://www.healthcostinstitute.org/\" target=\"_blank\">Health Care Cost Institute\u003c/a>, in Washington, D.C. The way billing and reimbursement work in health care is extremely complicated, he says.\u003c/p>\n\u003cp>\"There are 8,000 procedure codes, tens of thousands of diagnostic codes, a million different providers, and hundreds of insurance companies,\" says Newman. Calculators are often based on one specific procedure, so they may not reflect all that happens and is billed for during a visit. In that way, he says, \"this is probably going to be as good as it gets.\"\u003c/p>\n\u003cp>But de Brantes thinks much more improvement is possible.\u003c/p>\n\u003cp>\"It's not that difficult. It really — technologically — is not that difficult at all,\" he says.\u003c/p>\n\u003cp>The information people like the Savetts are seeking exists in the health care system, de Brantes says, even if in some cases it is hidden behind contract agreements. The bigger problem, he says, is that there is no internal pressure to make the online calculator work as well as it could. Health care has thrived in an opaque environment where costs are hard to find.\u003c/p>\n\u003cp>But the needle is starting to move. Employers are demanding these tools for their employees. And several \u003ca href=\"http://www.npr.org/sections/health-shots/2014/11/05/360351551/how-much-is-that-mri-really-massachusetts-shines-a-light\" target=\"_blank\">states mandate\u003c/a> public reporting of \u003ca href=\"http://www.npr.org/sections/health-shots/2014/02/12/276001379/elusive-goal-a-transparent-price-list-for-health-care\" target=\"_blank\">price information\u003c/a>.\u003c/p>\n\u003cp>As for Scott and Kate Savett, the current climate has turned each of them into a new breed of health care consumer: a savvy one.\u003c/p>\n\u003cp>Scott says he knows they are approaching their $8,000 out-of- pocket cap for the year, which means insurance will soon cover the entire cost of their care. But he doesn't want to give in. He wants to see improvements.\u003c/p>\n\u003cp>\"I would rather crawl to that $8,000 cap than sprint to it,\" he says. \"I know we're going to get there this year, unfortunately, but to blow it all on an MRI that's excessively priced rubs me the wrong way.\"\u003c/p>\n\u003cp>A few weeks after we first talked, Savett received a bill for his MRI. Turns out, it's pretty close to what the estimator predicted it would be — $1,100. He says he will keep using the tool. But he sees it as an imperfect clue rather than a price tag.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>This story is part of NPR's reporting partnership with WHYY's \u003ca href=\"http://www.newsworks.org/index.php/thepulse\" target=\"_blank\">The Pulse\u003c/a> and \u003c/em>\u003ca href=\"http://www.kaiserhealthnews.org\" target=\"_blank\">Kaiser Health News\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">\u003c/div>\n\n","blocks":[],"excerpt":"Savvy patients want the best medical care for the best deal, and online calculators seem like a great way to compare the cost of common scans and procedures. But many are inaccurate.","status":"publish","parent":0,"modified":1448929129,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":37,"wordCount":1184},"headData":{"title":"Patients Want To Price-Shop For Care, But Online Tools Unreliable | KQED","description":"Savvy patients want the best medical care for the best deal, and online calculators seem like a great way to compare the cost of common scans and procedures. But many are inaccurate.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Patients Want To Price-Shop For Care, But Online Tools Unreliable","datePublished":"2015-11-30T21:23:09.000Z","dateModified":"2015-12-01T00:18:49.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"116325 http://ww2.kqed.org/stateofhealth/?p=116325","disqusUrl":"https://ww2.kqed.org/stateofhealth/2015/11/30/patients-want-to-price-shop-for-care-but-online-tools-unreliable/","disqusTitle":"Patients Want To Price-Shop For Care, But Online Tools Unreliable","source":"NPR","sourceUrl":"http://www.npr.org/sections/health-shots/2015/11/30/453087857/patients-want-to-price-shop-for-care-but-online-tools-unreliable","nprByline":"Elana Gordon","nprStoryId":"453087857","nprApiLink":"http://api.npr.org/query?id=453087857&apiKey=MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004","nprHtmlLink":"http://www.npr.org/sections/health-shots/2015/11/30/453087857/patients-want-to-price-shop-for-care-but-online-tools-unreliable?ft=nprml&f=453087857","nprRetrievedStory":"1","nprPubDate":"Mon, 30 Nov 2015 14:33:00 -0500","nprStoryDate":"Mon, 30 Nov 2015 04:54:00 -0500","nprLastModifiedDate":"Mon, 30 Nov 2015 14:33:55 -0500","nprAudio":"http://pd.npr.org/anon.npr-mp3/npr/me/2015/11/20151130_me_patients_want_to_price-shop_for_care_but_online_tools_unreliable.mp3?orgId=432&topicId=1128&d=305&p=3&story=453087857&t=progseg&e=457831498&seg=5&ft=nprml&f=453087857","nprAudioM3u":"http://api.npr.org/m3u/1457837780-c9e430.m3u?orgId=432&topicId=1128&d=305&p=3&story=453087857&t=progseg&e=457831498&seg=5&ft=nprml&f=453087857","path":"/stateofhealth/116325/patients-want-to-price-shop-for-care-but-online-tools-unreliable","audioUrl":"http://pd.npr.org/anon.npr-mp3/npr/me/2015/11/20151130_me_patients_want_to_price-shop_for_care_but_online_tools_unreliable.mp3?orgId=432&topicId=1128&d=305&p=3&story=453087857&t=progseg&e=457831498&seg=5&ft=nprml&f=453087857","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Kate and Scott Savett were trying to be responsible when they needed some medical care. They live about an hour north of Philadelphia with their dog, Frankie. Scott, 43, is a chemist and designs software for labs; Kate, 37, works in life insurance.\u003c/p>\n\u003cp>They buy their health insurance through Scott's job, and to keep their premiums affordable, they chose a high-deductible plan. They understood from the beginning that this would mean shopping carefully when they needed care, because costs can vary a lot among doctors and hospitals.\u003c/p>\n\u003cp>For years the couple didn't use their insurance much — but that all changed this year.\u003c/p>\n\u003cfigure id=\"attachment_116326\" class=\"wp-caption alignright\" style=\"max-width: 400px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/11/cost-calculator-1-04d8443fd5934c64fa38d6ff6cbe9a21e21b9101.jpg\">\u003cimg class=\"wp-image-116326 size-thumbnail\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/11/cost-calculator-1-04d8443fd5934c64fa38d6ff6cbe9a21e21b9101-400x300.jpg\" alt=\"Kate and Scott Savett, of Allentown, PA, at an event of the Greater Delaware Valley chapter of the National MS Society, in Philadelphia, PA.\" width=\"400\" height=\"300\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2015/11/cost-calculator-1-04d8443fd5934c64fa38d6ff6cbe9a21e21b9101-400x300.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2015/11/cost-calculator-1-04d8443fd5934c64fa38d6ff6cbe9a21e21b9101-800x600.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2015/11/cost-calculator-1-04d8443fd5934c64fa38d6ff6cbe9a21e21b9101-1440x1080.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2015/11/cost-calculator-1-04d8443fd5934c64fa38d6ff6cbe9a21e21b9101-1180x885.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2015/11/cost-calculator-1-04d8443fd5934c64fa38d6ff6cbe9a21e21b9101-960x720.jpg 960w\" sizes=\"(max-width: 400px) 100vw, 400px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Kate and Scott Savett, of Allentown, Pennsylvania, at an event of the Greater Delaware Valley chapter of the National MS Society, in Philadelphia. \u003ccite>(Bastiaan Slabbers for NPR)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Kate was diagnosed with multiple sclerosis in January. Doctors did a lot of tests and then follow-up tests. On top of that, Scott needed some imaging tests for a spinal issue.\u003c/p>\n\u003cp>Under their insurance plan, the two have to pay in full for the first $3,000 of their combined care. After that, they still have to pay 20 percent of the cost, until they reach a total of $8,000 in out-of-pocket expenses.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>That experience made them want to find the best care for the best deal. But how?\u003c/p>\n\u003cp>They investigated, using an online cost estimator offered through their insurance company.\u003c/p>\n\u003cp>Scott logs in to use the tool, and searches for the typical cost of MRI scans in his region. The online calculator tells him the average cost is $1,270; the lowest is $512 and the \"above average\" is $1,790.\u003c/p>\n\u003cp>The tool then produced a list of different providers and an estimate of how much they will specifically charge under the plan the Savetts have.\u003c/p>\n\u003cp>At first, this kind of information seemed great to the couple. But it quickly proved to be quite the headache.\u003c/p>\n\u003cp>A few days before Kate was scheduled to have her first MRI, she and Scott got a call from the radiology office, saying that the scan would cost them $2,400. They were shocked — the online calculator had told them it would only be about $500.\u003c/p>\n\u003cp>What's the source of the disconnect?\u003c/p>\n\u003cp>A hospital had bought the imaging center and raised the price.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>There were misquotes on other procedures, too. The Savetts received some bills from health providers that were as much as $1,000 higher than the price the online calculator had led them to expect. Another time, they couldn't find any listings at all for a procedure one of them needed.\u003c/p>\n\u003cp>The two quickly plowed through their $3,000 deductible. Financial planning became increasingly difficult. They delayed buying a new water heater for their house.\u003c/p>\n\u003cp>\"It's hard for us to pull the trigger on that, knowing that another bill could be coming around the corner,\" Kate says.\u003c/p>\n\u003cp>It's unclear how common these inaccuracies with online estimators are, but the tools \u003cem>are\u003c/em> becoming more popular, as patients shoulder a bigger share of the cost of their medical care. Outside companies are developing the online calculators, and most insurers offer them.\u003c/p>\n\u003cp>\"Each one of them — whether it's Aetna, United, Cigna — they all have something,\" says \u003ca href=\"http://www.hci3.org/about_hci3/team/francois-de-brantes-ms-mba-executive-director\" target=\"_blank\">Francois de Brantes\u003c/a>, director of the Health Care Incentives Improvement Institute, a nonprofit based in Connecticut. De Brantes has been \u003ca href=\"http://www.catalyzepaymentreform.org/images/Accuracy.pdf\" target=\"_blank\">paying close attention\u003c/a> to price-transparency tools.\u003c/p>\n\u003cp>\"There's lots and lots of variability in the information that's provided to consumers,\" he says.\u003c/p>\n\u003cp>Some of the estimators reflect an aggregate range of possible costs; others are based on historic pricing, or claims data from varying sources. Many, he says, are limited in the type of procedures they include.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>As for \u003ca href=\"http://www.uhc.com/individual-and-family/why-uhc/programs-tools/myhealthcare-cost-estimator\" target=\"_blank\">United Healthare's cost estimator\u003c/a> — the one the Savetts used — Craig Hankins, the insurer's vice president of consumer engagement products, gives it an 8 out of 10 in terms of accuracy.\u003c/p>\n\u003cp>\"Right now, I would say if we look at our tool, relative to others that are offered, I would say ours is average — if not above average — in terms of breadth of services as well as accuracy,\" Hankins says.\u003c/p>\n\u003cp>UHC's cost calculator is based on current information, he says, adding that it is in the insurer's interest to have the online tool work. If members get care at an acceptable cost, that saves everyone money.\u003c/p>\n\u003cp>But, he says, the tool has limits — it's hard to predict what a particular doctor will actually \u003cem>do\u003c/em> during an exam, treatment, or office visit, and how he or she will bill for it.\u003c/p>\n\u003cp>That gets at a deeper challenge with these online estimators, says David Newman, director of the nonprofit \u003ca href=\"http://www.healthcostinstitute.org/\" target=\"_blank\">Health Care Cost Institute\u003c/a>, in Washington, D.C. The way billing and reimbursement work in health care is extremely complicated, he says.\u003c/p>\n\u003cp>\"There are 8,000 procedure codes, tens of thousands of diagnostic codes, a million different providers, and hundreds of insurance companies,\" says Newman. Calculators are often based on one specific procedure, so they may not reflect all that happens and is billed for during a visit. In that way, he says, \"this is probably going to be as good as it gets.\"\u003c/p>\n\u003cp>But de Brantes thinks much more improvement is possible.\u003c/p>\n\u003cp>\"It's not that difficult. It really — technologically — is not that difficult at all,\" he says.\u003c/p>\n\u003cp>The information people like the Savetts are seeking exists in the health care system, de Brantes says, even if in some cases it is hidden behind contract agreements. The bigger problem, he says, is that there is no internal pressure to make the online calculator work as well as it could. Health care has thrived in an opaque environment where costs are hard to find.\u003c/p>\n\u003cp>But the needle is starting to move. Employers are demanding these tools for their employees. And several \u003ca href=\"http://www.npr.org/sections/health-shots/2014/11/05/360351551/how-much-is-that-mri-really-massachusetts-shines-a-light\" target=\"_blank\">states mandate\u003c/a> public reporting of \u003ca href=\"http://www.npr.org/sections/health-shots/2014/02/12/276001379/elusive-goal-a-transparent-price-list-for-health-care\" target=\"_blank\">price information\u003c/a>.\u003c/p>\n\u003cp>As for Scott and Kate Savett, the current climate has turned each of them into a new breed of health care consumer: a savvy one.\u003c/p>\n\u003cp>Scott says he knows they are approaching their $8,000 out-of- pocket cap for the year, which means insurance will soon cover the entire cost of their care. But he doesn't want to give in. He wants to see improvements.\u003c/p>\n\u003cp>\"I would rather crawl to that $8,000 cap than sprint to it,\" he says. \"I know we're going to get there this year, unfortunately, but to blow it all on an MRI that's excessively priced rubs me the wrong way.\"\u003c/p>\n\u003cp>A few weeks after we first talked, Savett received a bill for his MRI. Turns out, it's pretty close to what the estimator predicted it would be — $1,100. He says he will keep using the tool. But he sees it as an imperfect clue rather than a price tag.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>This story is part of NPR's reporting partnership with WHYY's \u003ca href=\"http://www.newsworks.org/index.php/thepulse\" target=\"_blank\">The Pulse\u003c/a> and \u003c/em>\u003ca href=\"http://www.kaiserhealthnews.org\" target=\"_blank\">Kaiser Health News\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">\u003c/div>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/116325/patients-want-to-price-shop-for-care-but-online-tools-unreliable","authors":["byline_stateofhealth_116325"],"series":["stateofhealth_2492"],"categories":["stateofhealth_2442"],"tags":["stateofhealth_799"],"featImg":"stateofhealth_116348","label":"source_stateofhealth_116325"},"stateofhealth_98479":{"type":"posts","id":"stateofhealth_98479","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"98479","score":null,"sort":[1445967190000]},"guestAuthors":[],"slug":"please-look-beyond-monthly-premium-when-picking-health-insurance","title":"Please -- Look Beyond Monthly Premium When Picking Health Insurance","publishDate":1445967190,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{},"content":"\u003cp>If you’re not already in the midst of picking your health coverage for next year, you soon may be.\u003c/p>\n\u003cp>If at all possible, please don’t base your decision solely on the cost of monthly premiums.\u003c/p>\n\u003cp>Let’s say you have asthma. Out of 10 major \u003ca href=\"https://www.healthcare.gov/glossary/health-maintenance-organization-hmo/\" target=\"_blank\">Health Maintenance Organizations \u003c/a>(HMOs) recently ranked in California, three received a “poor” rating for asthma care, five were ranked “fair” and two got “excellent.”\u003c/p>\n\u003cp>You might want to know which is which.\u003c/p>\n\u003cp>“If you have substandard care … through your health plan, paying any amount of money is not a good trade-off,” says Beth Abbott, director of the state \u003ca href=\"http://www.opa.ca.gov/Pages/Home.aspx\" target=\"_blank\">Office of the Patient Advocate \u003c/a>(OPA), which provides the rankings. “People should consider the interaction of both cost and quality.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Today I’ll point you to some resources that will help you compare plans on their care and patient satisfaction.\u003c/p>\n\u003cp>I also want to acknowledge again that while costs are definitely a critical component of your decision, don’t make premiums the only criterion.\u003c/p>\n\u003cp>\u003cstrong>Q: I have health insurance through my employer and open enrollment is coming up. It would make my life easier just to stay in the same plan I’m in. Is that a good idea?\u003c/strong>\u003c/p>\n\u003cp>A: Don’t automatically assume that the plan you’re in now will be the best plan for you next year.\u003c/p>\n\u003cp>Why? Doctors fall in and out of networks. Premiums, co-pays and deductibles often rise. And your plan might not provide the best care for your current medical needs.\u003c/p>\n\u003cp>Let’s start with some basics. For most people, open enrollment will be the only chance to buy or change your health insurance each year. But the time frame depends on where you get it:\u003c/p>\n\u003cul>\n\u003cli>If you have job-based insurance, you usually enroll for the coming year during the fall. Check with your human resources department for exact dates.\u003c/li>\n\u003cli>If you buy individual or family plans from the state health insurance exchange, \u003ca href=\"http://www.coveredca.com\" target=\"_blank\">Covered California,\u003c/a> or the open market, open enrollment for 2016 starts Nov. 1 and ends Jan. 31, 2016. If you already have a Covered California plan and want to stick with it, you can start the renewal process now.\u003c/li>\n\u003cli>Open enrollment for Medicare recipients began Oct. 15 and ends Dec. 7. \u003ca href=\"https://www.medicare.gov/sign-up-change-plans/decide-how-to-get-medicare/whats-medicare/what-is-medicare.html\" target=\"_blank\">Medicare\u003c/a> is the federal health insurance program for people 65 and older and those with kidney failure and certain disabilities.\u003c/li>\n\u003cli>You can enroll in\u003ca href=\"http://www.dhcs.ca.gov/services/medi-cal/pages/whatismedi-cal.aspx\" target=\"_blank\"> Medi-Cal\u003c/a>, the state’s version of the federal Medicaid program for low-income residents, any time of year if you’re eligible.\u003c/li>\n\u003c/ul>\n\u003cp>The biggest chunk of insured Californians have private insurance, either purchased through their employer or from Covered California or the open market. I’m going to focus on them.\u003c/p>\n\u003cp>The OPA report cards (find them at www.opa.ca.gov) grade the health plans and doctor groups that serve more than 16 million Californians, most of whom get their insurance through work.\u003c/p>\n\u003cp>Recently updated for 2015-2016, they offer two categories of ratings.\u003c/p>\n\u003cul>\n\u003cli>Member satisfaction: Patients rank their health plans and doctor groups on customer service, ease (and speed) of obtaining care and other measures.\u003c/li>\n\u003cli>Clinical data: These rankings measure whether plans meet recommended care guidelines in a number of areas, including diabetes, maternity, heart and mental health care.\u003c/li>\n\u003c/ul>\n\u003cp>The plans differ dramatically on some measures. For instance, as with asthma, HMOs rank from poor to excellent when it comes to maternity care. Drill into the rankings to learn which plans do better at prenatal and post-birth visits than others.\u003c/p>\n\u003cp>Beyond rankings, if you click on a health plan’s name, you can inspect customer service options and hours, which can be critical if you’re dealing with a sick child in the middle of the night and need advice, Abbott says. Some are open 24/7, including weekends. Others only answer the phone from 8 a.m. to 5 p.m. on weekdays.\u003c/p>\n\u003cp>“Some don’t have an after-hours number you can call,” she says.\u003c/p>\n\u003cp>If you’re buying insurance from Covered California, the agency this year will offer some plan ratings based on enrollee experience and opinion, not clinical data. You can find those star ratings when you’re shopping for plans on its website: \u003ca href=\"http://www.coveredca.com\" target=\"_blank\">www.CoveredCA.com\u003c/a>.\u003c/p>\n\u003cp>If you’re looking for clinical data, use the OPA report cards as a proxy, Abbott suggests. But beware that insurers sell different plans to their job-based customers and Covered California enrollees. Doctor networks, price structure and other factors differ.\u003c/p>\n\u003cp>Now, back to cost.\u003c/p>\n\u003cp>Don’t ignore the amount of money you will owe when you actually receive care, such as the deductibles, co-pays and other out-of-pocket costs that can easily climb into the thousands of dollars. (A \u003ca href=\"https://www.healthcare.gov/glossary/deductible/\" target=\"_blank\">deductible\u003c/a>, for instance, is the amount you owe for covered health care services before your insurance starts to pay.)\u003c/p>\n\u003cp>In general, the health plans with the lowest premiums have the highest out-of-pocket costs.\u003c/p>\n\u003cp>In Covered California parlance, that’s a bronze plan. For 2016, an individual who buys a basic bronze plan will face a $6,000 deductible for medical costs and $500 for drugs, which equals the plan’s $6,500 out-of-pocket maximum. (Double those figures to get the family limits.)\u003c/p>\n\u003cp>People with job-based plans, too, are getting hit. A \u003ca href=\"http://kff.org/health-costs/press-release/employer-family-health-premiums-rise-4-percent-to-17545-in-2015-extending-a-decade-long-trend-of-relatively-moderate-increases/\" target=\"_blank\">recent Kaiser Family Foundation analysis \u003c/a>of workplace benefits found that both the share of workers with deductibles and the size of deductibles have spiked. Together, they account for a 67 percent increase in deductibles since 2010, dwarfing the rise in premiums, workers’ wages and general inflation.\u003c/p>\n\u003cp>If you’re considering a high-deductible plan because of its lower premium, do the math ahead of time and understand all of your financial obligations, says Lucien Wulsin, executive director of the \u003ca href=\"http://itup.org/\" target=\"_blank\">Insure the Uninsured Project,\u003c/a> which advocates for California’s uninsured population.\u003c/p>\n\u003cp>If you’re a Covered California customer in particular, Wulsin urges you to check if you’re eligible for \u003ca href=\"http://www.coveredca.com/individuals-and-families/getting-covered/coverage-basics/coverage-levels/\" target=\"_blank\">an “enhanced” silver plan\u003c/a> based on your income. These plans offer subsidies that lower your out-of-pocket costs, but you must choose the silver level to receive them.\u003c/p>\n\u003cp>“When people are choosing these plans, they have to have their eyes wide open,” he says. “You can say, ‘I’m healthy today,’ then have an accident tomorrow.”\u003c/p>\n\u003cp>In other words, how many of you have $6,500 lying around for your next unplanned visit to the ER?\u003c/p>\n\u003cp>\u003cem>Questions for Emily: \u003ca href=\"askemily@usc.edu\" target=\"_blank\">AskEmily@usc.edu\u003c/a>\u003c/em>\u003c/p>\n\u003cp>\u003cem>Click\u003c/em>\u003cem> \u003c/em>\u003ca href=\"http://centerforhealthreporting.org/project/answers-consumer-questions-about-obamacare\" target=\"_blank\">here\u003c/a>\u003cem> \u003c/em>\u003cem>to find\u003c/em>\u003cem> \u003c/em>\u003cem>previous Ask Emily columns.\u003c/em>\u003cem> \u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>The \u003ca href=\"http://centerforhealthreporting.org\" target=\"_blank\">CHCF Center for Health Reporting\u003c/a> partners with news organizations to cover California health policy. Located at the \u003ca href=\"http://annenberg.usc.edu\" target=\"_blank\">USC Annenberg School for Communication and Journalism\u003c/a>, it is funded by the nonpartisan \u003ca href=\"http://www.chcf.org\" target=\"_blank\">California HealthCare Foundation\u003c/a>.\u003c/p>\n\n","blocks":[],"excerpt":"For California plans, consumers can look at quality of care and satisfaction. Think about the amount of the deductible, too. ","status":"publish","parent":0,"modified":1445992964,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":33,"wordCount":1176},"headData":{"title":"Please -- Look Beyond Monthly Premium When Picking Health Insurance | KQED","description":"For California plans, consumers can look at quality of care and satisfaction. Think about the amount of the deductible, too. ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Please -- Look Beyond Monthly Premium When Picking Health Insurance","datePublished":"2015-10-27T17:33:10.000Z","dateModified":"2015-10-28T00:42:44.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"98479 http://ww2.kqed.org/stateofhealth/?p=98479","disqusUrl":"https://ww2.kqed.org/stateofhealth/2015/10/27/please-look-beyond-monthly-premium-when-picking-health-insurance/","disqusTitle":"Please -- Look Beyond Monthly Premium When Picking Health Insurance","source":"CHCF Center for Health Reporting","sourceUrl":"http://centerforhealthreporting.org/article/despite-expanded-health-insurance-la-county-faces-big-challenges","nprByline":"Emily Bazar","path":"/stateofhealth/98479/please-look-beyond-monthly-premium-when-picking-health-insurance","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>If you’re not already in the midst of picking your health coverage for next year, you soon may be.\u003c/p>\n\u003cp>If at all possible, please don’t base your decision solely on the cost of monthly premiums.\u003c/p>\n\u003cp>Let’s say you have asthma. Out of 10 major \u003ca href=\"https://www.healthcare.gov/glossary/health-maintenance-organization-hmo/\" target=\"_blank\">Health Maintenance Organizations \u003c/a>(HMOs) recently ranked in California, three received a “poor” rating for asthma care, five were ranked “fair” and two got “excellent.”\u003c/p>\n\u003cp>You might want to know which is which.\u003c/p>\n\u003cp>“If you have substandard care … through your health plan, paying any amount of money is not a good trade-off,” says Beth Abbott, director of the state \u003ca href=\"http://www.opa.ca.gov/Pages/Home.aspx\" target=\"_blank\">Office of the Patient Advocate \u003c/a>(OPA), which provides the rankings. “People should consider the interaction of both cost and quality.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Today I’ll point you to some resources that will help you compare plans on their care and patient satisfaction.\u003c/p>\n\u003cp>I also want to acknowledge again that while costs are definitely a critical component of your decision, don’t make premiums the only criterion.\u003c/p>\n\u003cp>\u003cstrong>Q: I have health insurance through my employer and open enrollment is coming up. It would make my life easier just to stay in the same plan I’m in. Is that a good idea?\u003c/strong>\u003c/p>\n\u003cp>A: Don’t automatically assume that the plan you’re in now will be the best plan for you next year.\u003c/p>\n\u003cp>Why? Doctors fall in and out of networks. Premiums, co-pays and deductibles often rise. And your plan might not provide the best care for your current medical needs.\u003c/p>\n\u003cp>Let’s start with some basics. For most people, open enrollment will be the only chance to buy or change your health insurance each year. But the time frame depends on where you get it:\u003c/p>\n\u003cul>\n\u003cli>If you have job-based insurance, you usually enroll for the coming year during the fall. Check with your human resources department for exact dates.\u003c/li>\n\u003cli>If you buy individual or family plans from the state health insurance exchange, \u003ca href=\"http://www.coveredca.com\" target=\"_blank\">Covered California,\u003c/a> or the open market, open enrollment for 2016 starts Nov. 1 and ends Jan. 31, 2016. If you already have a Covered California plan and want to stick with it, you can start the renewal process now.\u003c/li>\n\u003cli>Open enrollment for Medicare recipients began Oct. 15 and ends Dec. 7. \u003ca href=\"https://www.medicare.gov/sign-up-change-plans/decide-how-to-get-medicare/whats-medicare/what-is-medicare.html\" target=\"_blank\">Medicare\u003c/a> is the federal health insurance program for people 65 and older and those with kidney failure and certain disabilities.\u003c/li>\n\u003cli>You can enroll in\u003ca href=\"http://www.dhcs.ca.gov/services/medi-cal/pages/whatismedi-cal.aspx\" target=\"_blank\"> Medi-Cal\u003c/a>, the state’s version of the federal Medicaid program for low-income residents, any time of year if you’re eligible.\u003c/li>\n\u003c/ul>\n\u003cp>The biggest chunk of insured Californians have private insurance, either purchased through their employer or from Covered California or the open market. I’m going to focus on them.\u003c/p>\n\u003cp>The OPA report cards (find them at www.opa.ca.gov) grade the health plans and doctor groups that serve more than 16 million Californians, most of whom get their insurance through work.\u003c/p>\n\u003cp>Recently updated for 2015-2016, they offer two categories of ratings.\u003c/p>\n\u003cul>\n\u003cli>Member satisfaction: Patients rank their health plans and doctor groups on customer service, ease (and speed) of obtaining care and other measures.\u003c/li>\n\u003cli>Clinical data: These rankings measure whether plans meet recommended care guidelines in a number of areas, including diabetes, maternity, heart and mental health care.\u003c/li>\n\u003c/ul>\n\u003cp>The plans differ dramatically on some measures. For instance, as with asthma, HMOs rank from poor to excellent when it comes to maternity care. Drill into the rankings to learn which plans do better at prenatal and post-birth visits than others.\u003c/p>\n\u003cp>Beyond rankings, if you click on a health plan’s name, you can inspect customer service options and hours, which can be critical if you’re dealing with a sick child in the middle of the night and need advice, Abbott says. Some are open 24/7, including weekends. Others only answer the phone from 8 a.m. to 5 p.m. on weekdays.\u003c/p>\n\u003cp>“Some don’t have an after-hours number you can call,” she says.\u003c/p>\n\u003cp>If you’re buying insurance from Covered California, the agency this year will offer some plan ratings based on enrollee experience and opinion, not clinical data. You can find those star ratings when you’re shopping for plans on its website: \u003ca href=\"http://www.coveredca.com\" target=\"_blank\">www.CoveredCA.com\u003c/a>.\u003c/p>\n\u003cp>If you’re looking for clinical data, use the OPA report cards as a proxy, Abbott suggests. But beware that insurers sell different plans to their job-based customers and Covered California enrollees. Doctor networks, price structure and other factors differ.\u003c/p>\n\u003cp>Now, back to cost.\u003c/p>\n\u003cp>Don’t ignore the amount of money you will owe when you actually receive care, such as the deductibles, co-pays and other out-of-pocket costs that can easily climb into the thousands of dollars. (A \u003ca href=\"https://www.healthcare.gov/glossary/deductible/\" target=\"_blank\">deductible\u003c/a>, for instance, is the amount you owe for covered health care services before your insurance starts to pay.)\u003c/p>\n\u003cp>In general, the health plans with the lowest premiums have the highest out-of-pocket costs.\u003c/p>\n\u003cp>In Covered California parlance, that’s a bronze plan. For 2016, an individual who buys a basic bronze plan will face a $6,000 deductible for medical costs and $500 for drugs, which equals the plan’s $6,500 out-of-pocket maximum. (Double those figures to get the family limits.)\u003c/p>\n\u003cp>People with job-based plans, too, are getting hit. A \u003ca href=\"http://kff.org/health-costs/press-release/employer-family-health-premiums-rise-4-percent-to-17545-in-2015-extending-a-decade-long-trend-of-relatively-moderate-increases/\" target=\"_blank\">recent Kaiser Family Foundation analysis \u003c/a>of workplace benefits found that both the share of workers with deductibles and the size of deductibles have spiked. Together, they account for a 67 percent increase in deductibles since 2010, dwarfing the rise in premiums, workers’ wages and general inflation.\u003c/p>\n\u003cp>If you’re considering a high-deductible plan because of its lower premium, do the math ahead of time and understand all of your financial obligations, says Lucien Wulsin, executive director of the \u003ca href=\"http://itup.org/\" target=\"_blank\">Insure the Uninsured Project,\u003c/a> which advocates for California’s uninsured population.\u003c/p>\n\u003cp>If you’re a Covered California customer in particular, Wulsin urges you to check if you’re eligible for \u003ca href=\"http://www.coveredca.com/individuals-and-families/getting-covered/coverage-basics/coverage-levels/\" target=\"_blank\">an “enhanced” silver plan\u003c/a> based on your income. These plans offer subsidies that lower your out-of-pocket costs, but you must choose the silver level to receive them.\u003c/p>\n\u003cp>“When people are choosing these plans, they have to have their eyes wide open,” he says. “You can say, ‘I’m healthy today,’ then have an accident tomorrow.”\u003c/p>\n\u003cp>In other words, how many of you have $6,500 lying around for your next unplanned visit to the ER?\u003c/p>\n\u003cp>\u003cem>Questions for Emily: \u003ca href=\"askemily@usc.edu\" target=\"_blank\">AskEmily@usc.edu\u003c/a>\u003c/em>\u003c/p>\n\u003cp>\u003cem>Click\u003c/em>\u003cem> \u003c/em>\u003ca href=\"http://centerforhealthreporting.org/project/answers-consumer-questions-about-obamacare\" target=\"_blank\">here\u003c/a>\u003cem> \u003c/em>\u003cem>to find\u003c/em>\u003cem> \u003c/em>\u003cem>previous Ask Emily columns.\u003c/em>\u003cem> \u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The \u003ca href=\"http://centerforhealthreporting.org\" target=\"_blank\">CHCF Center for Health Reporting\u003c/a> partners with news organizations to cover California health policy. Located at the \u003ca href=\"http://annenberg.usc.edu\" target=\"_blank\">USC Annenberg School for Communication and Journalism\u003c/a>, it is funded by the nonpartisan \u003ca href=\"http://www.chcf.org\" target=\"_blank\">California HealthCare Foundation\u003c/a>.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/98479/please-look-beyond-monthly-premium-when-picking-health-insurance","authors":["byline_stateofhealth_98479"],"categories":["stateofhealth_2442"],"tags":["stateofhealth_368","stateofhealth_799","stateofhealth_2519"],"featImg":"stateofhealth_98924","label":"source_stateofhealth_98479"},"stateofhealth_98425":{"type":"posts","id":"stateofhealth_98425","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"98425","score":null,"sort":[1445889630000]},"guestAuthors":[],"slug":"in-fresno-car-washes-common-way-to-pay-for-funerals","title":"In Fresno, Car Washes Common Way to Pay for Funerals","publishDate":1445889630,"format":"standard","headTitle":"Vital Signs | State of Health | KQED News","labelTerm":{"term":2363,"site":"stateofhealth"},"content":"\u003cp>As expensive as medical care can be, it also costs a lot to die. Evangelina Quintanilla learned this a year ago when she lost her father, and again when her mother passed away in September.\u003c/p>\n\u003cp>Quintanilla, a single mother of eight in Fresno, couldn’t afford a funeral for either of her parents. She maxed out all her credit cards to pay for her father’s services. Because she was still paying off those bills when her mother died a year later, she had to get creative -- so she held a car wash.\u003c/p>\n\u003cp>Washing cars for funeral donations is not uncommon in Fresno, where over a quarter of residents fall below the federal poverty level. Drive along the city’s busiest boulevards on any weekend and you’re bound to see groups of kids holding up brightly colored posters showing the names and faces of family members who died.\u003c/p>\n\u003cp>[soundcloud url=\"https://api.soundcloud.com/tracks/229734373\" params=\"color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\" width=\"100%\" height=\"166\" iframe=\"true\" /]\u003c/p>\n\u003cp>After her mother's death, Quintanilla’s first idea was to beg. “We were just going to go from place to place by asking 50 cents, 25 cents, 10 cents,” she said. “Anything was good.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>But her sister had noticed people washing cars a few weeks earlier at a Central Fresno gas station. She urged Quintanilla to call and see if they could do the same. The owner said sure, but asked for a small fee and urged them to be frugal with water.\u003c/p>\n\u003cfigure id=\"attachment_98428\" class=\"wp-caption alignright\" style=\"max-width: 400px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/10/RS16910_IMG_2590-qut.jpg\">\u003cimg class=\"wp-image-98428 size-thumbnail\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/10/RS16910_IMG_2590-qut-400x300.jpg\" alt=\"In English and Spanish, a funeral home representative explains that donations are accepted to pay for Quintanilla’s mother's funeral.\" width=\"400\" height=\"300\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2015/10/RS16910_IMG_2590-qut-400x300.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/RS16910_IMG_2590-qut-800x600.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/RS16910_IMG_2590-qut-1440x1080.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/RS16910_IMG_2590-qut-1180x885.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/RS16910_IMG_2590-qut-960x720.jpg 960w\" sizes=\"(max-width: 400px) 100vw, 400px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">In English and Spanish, a funeral home representative explains that donations are accepted to pay for Quintanilla’s mother's funeral. (Click to enlarge.) \u003ccite>(Kerry Klein/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>So Quintanilla and 20 or so family members set up folding chairs and lined up buckets of soapy water early on a Saturday morning in September. It was hot that day, over 90 degrees in the afternoon, and a light dusting of ash was blowing into the valley from the Rough Fire. It was a good day to find dirty cars -- and a miserable day to be out in the elements.\u003c/p>\n\u003cp>Quintanilla sat in a minivan while her children, cousins, aunts and uncles washed the pickup trucks and station wagons that rolled in. The 41-year-old is disabled; she has survived two strokes and suffers from high blood pressure and diabetes. Doctors have advised her not to work and warned her against exerting herself. “I’m like, ‘OK, tell me what I need to do. I need to be here for my kids. Tell me.’ ”\u003c/p>\n\u003cp>Many of these same health problems led to the death of Quintanilla’s mother. Just like her daughter, she suffered a string of chronic health issues, including diabetes. When she came down with a bad infection, her body ultimately couldn’t fend it off. She was in the hospital for a month before she died of sepsis. Quintanilla wonders if her mother’s fate could become her own. She says her brother jokes, “You’re probably next.”\u003c/p>\n\u003cp>When she can, she thinks back to a happy memory of her mother. “I never asked her age 'cause my mom used to tell people she was younger,” she says, in a fit of laughter. “My mom was in her 60s but she said she was 50.”\u003c/p>\n\u003cp>By about 4 p.m., Quintanilla says, they had washed around 75 cars and raised close to $600. But they still had a long way to go: Cremation services would cost at least $2,500. “We wanted to view her, but it costs more money,” she says. “Everything does.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>They still probably made more money than they would have from begging. “The biggest donation we got was $150,” she says, choking up. “I think everybody’s been generous.\"\u003c/p>\n\n","blocks":[],"excerpt":"Drive along the city’s busiest streets on weekends and you’ll see groups of kids holding up brightly colored posters showing family members who died.","status":"publish","parent":0,"modified":1445904309,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":14,"wordCount":675},"headData":{"title":"In Fresno, Car Washes Common Way to Pay for Funerals | KQED","description":"Drive along the city’s busiest streets on weekends and you’ll see groups of kids holding up brightly colored posters showing family members who died.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"In Fresno, Car Washes Common Way to Pay for Funerals","datePublished":"2015-10-26T20:00:30.000Z","dateModified":"2015-10-27T00:05:09.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"98425 http://ww2.kqed.org/stateofhealth/?p=98425","disqusUrl":"https://ww2.kqed.org/stateofhealth/2015/10/26/in-fresno-car-washes-common-way-to-pay-for-funerals/","disqusTitle":"In Fresno, Car Washes Common Way to Pay for Funerals","nprByline":"Kerry Klein","path":"/stateofhealth/98425/in-fresno-car-washes-common-way-to-pay-for-funerals","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>As expensive as medical care can be, it also costs a lot to die. Evangelina Quintanilla learned this a year ago when she lost her father, and again when her mother passed away in September.\u003c/p>\n\u003cp>Quintanilla, a single mother of eight in Fresno, couldn’t afford a funeral for either of her parents. She maxed out all her credit cards to pay for her father’s services. Because she was still paying off those bills when her mother died a year later, she had to get creative -- so she held a car wash.\u003c/p>\n\u003cp>Washing cars for funeral donations is not uncommon in Fresno, where over a quarter of residents fall below the federal poverty level. Drive along the city’s busiest boulevards on any weekend and you’re bound to see groups of kids holding up brightly colored posters showing the names and faces of family members who died.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003cdiv class='utils-parseShortcode-shortcodes-__shortcodes__shortcodeWrapper'>\n \u003ciframe width='100%' height='166'\n scrolling='no' frameborder='no'\n src='https://w.soundcloud.com/player/?url=https://api.soundcloud.com/tracks/229734373&visual=true&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false'\n title='https://api.soundcloud.com/tracks/229734373'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\u003cp>After her mother's death, Quintanilla’s first idea was to beg. “We were just going to go from place to place by asking 50 cents, 25 cents, 10 cents,” she said. “Anything was good.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>But her sister had noticed people washing cars a few weeks earlier at a Central Fresno gas station. She urged Quintanilla to call and see if they could do the same. The owner said sure, but asked for a small fee and urged them to be frugal with water.\u003c/p>\n\u003cfigure id=\"attachment_98428\" class=\"wp-caption alignright\" style=\"max-width: 400px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/10/RS16910_IMG_2590-qut.jpg\">\u003cimg class=\"wp-image-98428 size-thumbnail\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/10/RS16910_IMG_2590-qut-400x300.jpg\" alt=\"In English and Spanish, a funeral home representative explains that donations are accepted to pay for Quintanilla’s mother's funeral.\" width=\"400\" height=\"300\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2015/10/RS16910_IMG_2590-qut-400x300.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/RS16910_IMG_2590-qut-800x600.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/RS16910_IMG_2590-qut-1440x1080.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/RS16910_IMG_2590-qut-1180x885.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/RS16910_IMG_2590-qut-960x720.jpg 960w\" sizes=\"(max-width: 400px) 100vw, 400px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">In English and Spanish, a funeral home representative explains that donations are accepted to pay for Quintanilla’s mother's funeral. (Click to enlarge.) \u003ccite>(Kerry Klein/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>So Quintanilla and 20 or so family members set up folding chairs and lined up buckets of soapy water early on a Saturday morning in September. It was hot that day, over 90 degrees in the afternoon, and a light dusting of ash was blowing into the valley from the Rough Fire. It was a good day to find dirty cars -- and a miserable day to be out in the elements.\u003c/p>\n\u003cp>Quintanilla sat in a minivan while her children, cousins, aunts and uncles washed the pickup trucks and station wagons that rolled in. The 41-year-old is disabled; she has survived two strokes and suffers from high blood pressure and diabetes. Doctors have advised her not to work and warned her against exerting herself. “I’m like, ‘OK, tell me what I need to do. I need to be here for my kids. Tell me.’ ”\u003c/p>\n\u003cp>Many of these same health problems led to the death of Quintanilla’s mother. Just like her daughter, she suffered a string of chronic health issues, including diabetes. When she came down with a bad infection, her body ultimately couldn’t fend it off. She was in the hospital for a month before she died of sepsis. Quintanilla wonders if her mother’s fate could become her own. She says her brother jokes, “You’re probably next.”\u003c/p>\n\u003cp>When she can, she thinks back to a happy memory of her mother. “I never asked her age 'cause my mom used to tell people she was younger,” she says, in a fit of laughter. “My mom was in her 60s but she said she was 50.”\u003c/p>\n\u003cp>By about 4 p.m., Quintanilla says, they had washed around 75 cars and raised close to $600. But they still had a long way to go: Cremation services would cost at least $2,500. “We wanted to view her, but it costs more money,” she says. “Everything does.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>They still probably made more money than they would have from begging. “The biggest donation we got was $150,” she says, choking up. “I think everybody’s been generous.\"\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/98425/in-fresno-car-washes-common-way-to-pay-for-funerals","authors":["byline_stateofhealth_98425"],"series":["stateofhealth_2363"],"categories":["stateofhealth_11"],"tags":["stateofhealth_799","stateofhealth_2519"],"featImg":"stateofhealth_98426","label":"stateofhealth_2363"},"stateofhealth_95454":{"type":"posts","id":"stateofhealth_95454","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"95454","score":null,"sort":[1445446385000]},"guestAuthors":[],"slug":"yes-shopping-for-health-care-is-hard-but-dont-give-up","title":"Yes, Shopping for Health Care is Hard, But Don't Give Up","publishDate":1445446385,"format":"standard","headTitle":"Price Check | State of Health | KQED News","labelTerm":{},"content":"\u003cp>\u003cem>Editor's note: this essay comes to us from our \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" target=\"_blank\">PriceCheck\u003c/a> partner, Jeanne Pinder, the founder of \u003ca href=\"https://clearhealthcosts.com\" target=\"_blank\">ClearHealthCosts\u003c/a>. Her mission is improving transparency in health prices by giving consumers more power by lifting the veil on the opaque world of health care prices.\u003c/em>\u003c/p>\n\u003cp>Yes, people are shopping for health care. Some are better at it than others, and some providers and payers (read: doctors and insurers) are better than others about revealing information. We're always interested to hear when people who haven't encountered these truths come up against the real world. So when Sarah Kliff, the well-respected health care writer for Vox.com, wrote about her experience \u003ca href=\"http://www.vox.com/2015/10/19/9567991/health-care-shopping-mri\" target=\"_blank\">trying to get a better price for an MRI\u003c/a>, I was really interested.\u003c/p>\n\u003cp>In her story Kliff said she had a fracture that hadn't healed properly. After she spent weeks in a walking cast and saw little improvement, her doctor recommended an MRI. Kliff scheduled an MRI at an academic center, then heard from her insurance company that they had a better choice that was less expensive. That's where she went.\u003c/p>\n\u003cp>[contextly_sidebar id=\"hGVGNvKrsTsPnj7fRdvTeNOueVtv99Gh\"]But when she returned to her doctor for the results, he said that it was hard to for him to get the MRI scan, because he wasn't familiar with the facility she went to. She waited for awhile as the offices straightened this out. Then the doctor told her that the quality of the MRI was a little blurry, and he wanted a better version (that could have been done at the expensive academic medical center where she was first sent!). Still, the scan was good enough for the doctor to diagnose a fracture.\u003c/p>\n\u003cp>In Sarah's story she concluded that shopping for health care is hard.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>At \u003ca href=\"https://clearhealthcosts.com\" target=\"_blank\">ClearHealthCosts\u003c/a>, the company I founded, we've been studying and writing about this for years now, so I have a few observations.\u003c/p>\n\u003cp>My questions for Sarah:\u003c/p>\n\u003cul>\n\u003cli>Having been directed to a different MRI provider by the insurance company, did you ask the doctor if the quality at that provider is OK? This system is a mess, and we often hear of people being steered to a provider for reasons of money (the doctor's in-network, or the gastrointestinal doctor owns an interest in the GI center where she sends patients for a colonoscopy, etc) or for reasons of quality (this place has old machines; please don't go there).\u003c/li>\n\u003cli>Did you ask the same quality question of the insurance company that sent you to a different provider?\u003c/li>\n\u003cli>As a reporter, did you ask why there were no quality metrics posted publicly or made available in other ways? Quality metrics are in their infancy.\u003c/li>\n\u003c/ul>\n\u003cp>I also wonder if MRIs at the academic medical center where she was first sent ever has blurry scans.\u003c/p>\n\u003cp>I have a friend who works at a prestigious New York City hospital. When I asked him about the quality question, he laughed and said \"Every MRI that comes into [our hospital from another center] gets a sticker up in the corner that says, \"Poor quality. Must re-do,\" or words to that effect.\u003c/p>\n\u003cp>[contextly_sidebar id=\"PAvOhcs5QFWfXqbeuQwNRmx1NEHCybJ3\"]To his credit, he seemed shamefaced about this –- not gloating, but truly just acknowledging that this is common practice and that it’s ridiculous that every single MRI not performed at his hospital would be flawed.\u003c/p>\n\u003cp>Kliff said she’d saved her insurer money by going cheaper. But the insurer has power to save money itself: It contracts with both the expensive MRI provider and the inexpensive MRI provider. Why doesn’t it simply refuse to pay the higher rate? The answer, of course, depends on who you talk to: the expensive provider has market power; the expensive provider needs to get paid more because its care is better; the expensive provider needs to be compensated for uncompensated care, etc.\u003c/p>\n\u003cp>But the truth is: the money that Kliff saved her insurance company will not be finding its way back to her soon. High prices benefit many in the marketplace by creating an artificial view of pricing, and by scaring the pants off people. (“A $6,000 MRI? Wow, glad I have insurance, and glad they negotiated it down to $2,000! Whew!”)\u003c/p>\n\u003cp>For many people, having choice in where they go for health care is a foreign experience.\u003c/p>\n\u003cp>It's especially foreign for people who have not used much health care recently -- and also for younger people. They just haven't got as many health issues and may be more trusting than someone like me, who, at 61, has had her share of health care experiences.\u003c/p>\n\u003cp>Sarah's conclusion: \"My own health care experience is far from unique. But it was a helpful, first-person demonstration of how shopping for health care might not be a zero-sum game, and that even with basic services, there can be clear winners and losers.\"\u003c/p>\n\u003cp>My conclusion: Yes, it's hard. But we have to keep trying.\u003c/p>\n\u003cp>My advice to anyone who is trying to get good quality -- at a fair price:\u003c/p>\n\u003cul>\n\u003cli>Ask about quality.\u003cbr>\nIf they won't give you an answer, ask again.\u003cbr>\nAsk why not.\u003cbr>\nAsk who's making money off this.\u003c/li>\n\u003cli>Yes, the system makes it hard to get at the right answer. But that does not mean we should give up trying.\u003c/li>\n\u003c/ul>\n\u003cp>There are baby steps toward bringing more cost and quality transparency to health care. Here are some sites (in addition to PriceCheck or ClearHealthCosts):\u003c/p>\n\u003cul>\n\u003cli>\u003ca href=\"https://healthcarebluebook.com/page_ConsumerFront.aspx\" target=\"_blank\">Healthcare Bluebook\u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"http://www.cahealthcarecompare.org/search.jsp\" target=\"_blank\">California Healthcare Compare\u003c/a>\u003c/li>\n\u003c/ul>\n\u003cp>\u003c/p>\n\u003cp>People are saving money by asking questions about price. It won't always work perfectly, but I hear every day from people who have saved money by asking some questions and doing some research.\u003c/p>\n\n","blocks":[],"excerpt":null,"status":"publish","parent":0,"modified":1445447420,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":21,"wordCount":968},"headData":{"title":"Yes, Shopping for Health Care is Hard, But Don't Give Up | KQED","description":"Editor's note: this essay comes to us from our PriceCheck partner, Jeanne Pinder, the founder of ClearHealthCosts. Her mission is improving transparency in health prices by giving consumers more power by lifting the veil on the opaque world of health care prices. Yes, people are shopping for health care. Some are better at it than","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Yes, Shopping for Health Care is Hard, But Don't Give Up","datePublished":"2015-10-21T16:53:05.000Z","dateModified":"2015-10-21T17:10:20.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"95454 http://ww2.kqed.org/stateofhealth/?p=95454","disqusUrl":"https://ww2.kqed.org/stateofhealth/2015/10/21/yes-shopping-for-health-care-is-hard-but-dont-give-up/","disqusTitle":"Yes, Shopping for Health Care is Hard, But Don't Give Up","source":"ClearHealthCosts","sourceUrl":"https://clearhealthcosts.com","nprByline":"Jeanne Pinder","path":"/stateofhealth/95454/yes-shopping-for-health-care-is-hard-but-dont-give-up","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>Editor's note: this essay comes to us from our \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" target=\"_blank\">PriceCheck\u003c/a> partner, Jeanne Pinder, the founder of \u003ca href=\"https://clearhealthcosts.com\" target=\"_blank\">ClearHealthCosts\u003c/a>. Her mission is improving transparency in health prices by giving consumers more power by lifting the veil on the opaque world of health care prices.\u003c/em>\u003c/p>\n\u003cp>Yes, people are shopping for health care. Some are better at it than others, and some providers and payers (read: doctors and insurers) are better than others about revealing information. We're always interested to hear when people who haven't encountered these truths come up against the real world. So when Sarah Kliff, the well-respected health care writer for Vox.com, wrote about her experience \u003ca href=\"http://www.vox.com/2015/10/19/9567991/health-care-shopping-mri\" target=\"_blank\">trying to get a better price for an MRI\u003c/a>, I was really interested.\u003c/p>\n\u003cp>In her story Kliff said she had a fracture that hadn't healed properly. After she spent weeks in a walking cast and saw little improvement, her doctor recommended an MRI. Kliff scheduled an MRI at an academic center, then heard from her insurance company that they had a better choice that was less expensive. That's where she went.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>But when she returned to her doctor for the results, he said that it was hard to for him to get the MRI scan, because he wasn't familiar with the facility she went to. She waited for awhile as the offices straightened this out. Then the doctor told her that the quality of the MRI was a little blurry, and he wanted a better version (that could have been done at the expensive academic medical center where she was first sent!). Still, the scan was good enough for the doctor to diagnose a fracture.\u003c/p>\n\u003cp>In Sarah's story she concluded that shopping for health care is hard.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>At \u003ca href=\"https://clearhealthcosts.com\" target=\"_blank\">ClearHealthCosts\u003c/a>, the company I founded, we've been studying and writing about this for years now, so I have a few observations.\u003c/p>\n\u003cp>My questions for Sarah:\u003c/p>\n\u003cul>\n\u003cli>Having been directed to a different MRI provider by the insurance company, did you ask the doctor if the quality at that provider is OK? This system is a mess, and we often hear of people being steered to a provider for reasons of money (the doctor's in-network, or the gastrointestinal doctor owns an interest in the GI center where she sends patients for a colonoscopy, etc) or for reasons of quality (this place has old machines; please don't go there).\u003c/li>\n\u003cli>Did you ask the same quality question of the insurance company that sent you to a different provider?\u003c/li>\n\u003cli>As a reporter, did you ask why there were no quality metrics posted publicly or made available in other ways? Quality metrics are in their infancy.\u003c/li>\n\u003c/ul>\n\u003cp>I also wonder if MRIs at the academic medical center where she was first sent ever has blurry scans.\u003c/p>\n\u003cp>I have a friend who works at a prestigious New York City hospital. When I asked him about the quality question, he laughed and said \"Every MRI that comes into [our hospital from another center] gets a sticker up in the corner that says, \"Poor quality. Must re-do,\" or words to that effect.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>To his credit, he seemed shamefaced about this –- not gloating, but truly just acknowledging that this is common practice and that it’s ridiculous that every single MRI not performed at his hospital would be flawed.\u003c/p>\n\u003cp>Kliff said she’d saved her insurer money by going cheaper. But the insurer has power to save money itself: It contracts with both the expensive MRI provider and the inexpensive MRI provider. Why doesn’t it simply refuse to pay the higher rate? The answer, of course, depends on who you talk to: the expensive provider has market power; the expensive provider needs to get paid more because its care is better; the expensive provider needs to be compensated for uncompensated care, etc.\u003c/p>\n\u003cp>But the truth is: the money that Kliff saved her insurance company will not be finding its way back to her soon. High prices benefit many in the marketplace by creating an artificial view of pricing, and by scaring the pants off people. (“A $6,000 MRI? Wow, glad I have insurance, and glad they negotiated it down to $2,000! Whew!”)\u003c/p>\n\u003cp>For many people, having choice in where they go for health care is a foreign experience.\u003c/p>\n\u003cp>It's especially foreign for people who have not used much health care recently -- and also for younger people. They just haven't got as many health issues and may be more trusting than someone like me, who, at 61, has had her share of health care experiences.\u003c/p>\n\u003cp>Sarah's conclusion: \"My own health care experience is far from unique. But it was a helpful, first-person demonstration of how shopping for health care might not be a zero-sum game, and that even with basic services, there can be clear winners and losers.\"\u003c/p>\n\u003cp>My conclusion: Yes, it's hard. But we have to keep trying.\u003c/p>\n\u003cp>My advice to anyone who is trying to get good quality -- at a fair price:\u003c/p>\n\u003cul>\n\u003cli>Ask about quality.\u003cbr>\nIf they won't give you an answer, ask again.\u003cbr>\nAsk why not.\u003cbr>\nAsk who's making money off this.\u003c/li>\n\u003cli>Yes, the system makes it hard to get at the right answer. But that does not mean we should give up trying.\u003c/li>\n\u003c/ul>\n\u003cp>There are baby steps toward bringing more cost and quality transparency to health care. Here are some sites (in addition to PriceCheck or ClearHealthCosts):\u003c/p>\n\u003cul>\n\u003cli>\u003ca href=\"https://healthcarebluebook.com/page_ConsumerFront.aspx\" target=\"_blank\">Healthcare Bluebook\u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"http://www.cahealthcarecompare.org/search.jsp\" target=\"_blank\">California Healthcare Compare\u003c/a>\u003c/li>\n\u003c/ul>\n\u003cp>\u003c/p>\n\u003cp>People are saving money by asking questions about price. It won't always work perfectly, but I hear every day from people who have saved money by asking some questions and doing some research.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/95454/yes-shopping-for-health-care-is-hard-but-dont-give-up","authors":["byline_stateofhealth_95454"],"series":["stateofhealth_2492"],"categories":["stateofhealth_2442","stateofhealth_13"],"tags":["stateofhealth_393","stateofhealth_799"],"featImg":"stateofhealth_95829","label":"source_stateofhealth_95454"},"stateofhealth_82029":{"type":"posts","id":"stateofhealth_82029","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"82029","score":null,"sort":[1442941965000]},"guestAuthors":[],"slug":"employers-continue-to-shift-health-costs-to-workers-survey-finds","title":"Employers Continue to Shift Health Costs to Workers, Survey Finds","publishDate":1442941965,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>Employers are leaving a bigger chunk of the bill for care to workers who use their health insurance, and benefits experts see few signs of this trend slowing.\u003c/p>\n\u003cp>Most companies now offer health coverage that requires employees to pay an annual deductible before insurance kicks in, and the size of that deductible has soared in the past decade, \u003ca href=\"http://kff.org/health-costs/report/2015-employer-health-benefits-survey/\" target=\"_blank\">according to a survey \u003c/a>released Tuesday by the Kaiser Family Foundation and Health Research & Educational Trust.\u003c/p>\n\u003caside class=\"pullquote alignright\">A cost shift that is 'a quiet revolution in health insurance.'\u003c/aside>\n\u003cp>The average general deductible for workers with single coverage totaled $1,077 this year, compared with only $303 in 2006. That deductible has climbed nearly seven times faster than wages, on average, over the past five years.\u003c/p>\n\u003cp>\"That has an impact on family budgets,\" Kaiser CEO Drew Altman said.\u003c/p>\n\u003cp>The study also found that 46 percent of workers with single coverage have a deductible of $1,000 or more. That's up from only 10 percent in 2006. Kaiser's study didn't measure family coverage deductibles, which can be more complex, but researchers say those have grown as well.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Altman calls this cost shift a \"quiet revolution in health insurance,\" obscured in recent years by the health care overhaul's coverage expansion for people who don't have coverage through work.\u003c/p>\n\u003cp>\"It's funny, we used to think of $1,000 as a very high deductible, and now it's almost commonplace,\" he said. \"Consumers have much more skin in the game, and that may be fine if you're healthier and don't use a lot of health care. That could be a real problem if you're chronically ill.\"\u003c/p>\n\u003cfigure id=\"attachment_82031\" class=\"wp-caption aligncenter\" style=\"max-width: 765px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/09/Screen-Shot-2015-09-22-at-10.02.43-AM.png\">\u003cimg class=\"wp-image-82031 size-full\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/09/Screen-Shot-2015-09-22-at-10.02.43-AM.png\" alt=\"Worker contributions to health insurance have increased 83 percent in 10 years. \" width=\"765\" height=\"634\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2015/09/Screen-Shot-2015-09-22-at-10.02.43-AM.png 765w, https://ww2.kqed.org/app/uploads/sites/27/2015/09/Screen-Shot-2015-09-22-at-10.02.43-AM-400x332.png 400w\" sizes=\"(max-width: 765px) 100vw, 765px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Worker contributions to health insurance have increased 83 percent in 10 years.\u003c/figcaption>\u003c/figure>\n\u003cp>Employer-sponsored health insurance is the most common form of coverage in the United States, with about 147 million people enrolled. Companies of all sizes offer coverage as a way to keep workers and make sure they stay healthy. But years of rising costs have forced many businesses to scale back their coverage. One of the quickest ways they have to control the growth in premiums, or cost of coverage, without significantly changing the insurance is to raise an employee's deductible.\u003c/p>\n\u003cp>Altman said the increase in deductibles has helped restrain premium growth for the past several years. In 2015, premiums rose an average of 4 percent for single and family coverage.\u003c/p>\n\u003cp>The employer generally pays most of the premium and has the remaining share taken out of the employee's paycheck before taxes.\u003c/p>\n\u003cp>Kaiser's research found that the size of a health plan's deductible can depend on the employer. Small firms had an average of $1,836, while big businesses had $1,105. Many companies pair that coverage with accounts that let employees set aside money before taxes for medical expenses.\u003c/p>\n\u003cp>Commercial painting company Steve Reiff Inc. offers single coverage with a deductible of $5,950. The South Whitley, Indiana, company also helps cover about half the cost of that deductible with contributions to an employee health reimbursement arrangement account, Controller Eric Trump said.\u003c/p>\n\u003cp>The business switched to a high-deductible plan several years ago to help restrain premium growth. That move helped, but Trump worries about leaving roughly 30 people on their coverage with the high deductible.\u003c/p>\n\u003cp>\"It's really hard to like a lot of health insurance options right now,\" he said. \"It's still a big expense for people that are making $10 to $15 an hour.\"\u003c/p>\n\u003cp>Paducah, Kentucky, resident Emmett Krall says the annual deductible of $3,500 on his employer-sponsored health insurance makes him think about cost more than he wants to, especially since his 10-year-old son was diagnosed with Type 1 diabetes last year.\u003c/p>\n\u003cp>Krall said he has to come up with about $200 a month to cover his son's insulin, needles and pump. The 46-year-old carpet manufacturer sales representative said he has cut down on going out to eat, and he's watching where he spends his money.\u003c/p>\n\u003cp>\"It causes an anxiety and a stress on my part, because I do get stressed about it, and I don't want him to know about it,\" he said.\u003c/p>\n\u003cp>College professor Bill Cantor said he's seen his premium fall to only $95 a month for family coverage from around $300 since he switched to a high-deductible health plan a few years ago. He uses a health savings account to set aside money for expenses, and he likes how the plan has made him more aware of costs.\u003c/p>\n\u003cp>The 53-year-old said he caught a $200 mistake on a medical bill that he might have missed if insurance had just covered the claim.\u003c/p>\n\u003cp>\"I think it would hold down insurance rates more if people thought about their spending,\" said Cantor, who teaches information science and technology at Penn State's York, Pennsylvania, campus.\u003c/p>\n\u003cp>Kaiser's survey focused on benefits for this year and doesn't predict what will happen in 2016, something many workers will learn about in a couple of months when their employers detail coverage plans for the new year.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Kaiser Vice President Gary Claxton said he doesn't expect the trend toward higher deductibles to ease much in 2016. He noted that employers tend to make their coverage more generous as the economy improves. But companies still will be intent on controlling costs to prepare for an overhaul-imposed tax on expensive benefit plans that starts in 2018.\u003c/p>\n\n","blocks":[],"excerpt":"The average deductible has soared to over $1,000, compared to about $300 in 2006, far outpacing the growth of wages.","status":"publish","parent":0,"modified":1442963905,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":24,"wordCount":919},"headData":{"title":"Employers Continue to Shift Health Costs to Workers, Survey Finds | KQED","description":"The average deductible has soared to over $1,000, compared to about $300 in 2006, far outpacing the growth of wages.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Employers Continue to Shift Health Costs to Workers, Survey Finds","datePublished":"2015-09-22T17:12:45.000Z","dateModified":"2015-09-22T23:18:25.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"82029 http://ww2.kqed.org/stateofhealth/?p=82029","disqusUrl":"https://ww2.kqed.org/stateofhealth/2015/09/22/employers-continue-to-shift-health-costs-to-workers-survey-finds/","disqusTitle":"Employers Continue to Shift Health Costs to Workers, Survey Finds","nprByline":"Tom Murphy, Associated Press","path":"/stateofhealth/82029/employers-continue-to-shift-health-costs-to-workers-survey-finds","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Employers are leaving a bigger chunk of the bill for care to workers who use their health insurance, and benefits experts see few signs of this trend slowing.\u003c/p>\n\u003cp>Most companies now offer health coverage that requires employees to pay an annual deductible before insurance kicks in, and the size of that deductible has soared in the past decade, \u003ca href=\"http://kff.org/health-costs/report/2015-employer-health-benefits-survey/\" target=\"_blank\">according to a survey \u003c/a>released Tuesday by the Kaiser Family Foundation and Health Research & Educational Trust.\u003c/p>\n\u003caside class=\"pullquote alignright\">A cost shift that is 'a quiet revolution in health insurance.'\u003c/aside>\n\u003cp>The average general deductible for workers with single coverage totaled $1,077 this year, compared with only $303 in 2006. That deductible has climbed nearly seven times faster than wages, on average, over the past five years.\u003c/p>\n\u003cp>\"That has an impact on family budgets,\" Kaiser CEO Drew Altman said.\u003c/p>\n\u003cp>The study also found that 46 percent of workers with single coverage have a deductible of $1,000 or more. That's up from only 10 percent in 2006. Kaiser's study didn't measure family coverage deductibles, which can be more complex, but researchers say those have grown as well.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Altman calls this cost shift a \"quiet revolution in health insurance,\" obscured in recent years by the health care overhaul's coverage expansion for people who don't have coverage through work.\u003c/p>\n\u003cp>\"It's funny, we used to think of $1,000 as a very high deductible, and now it's almost commonplace,\" he said. \"Consumers have much more skin in the game, and that may be fine if you're healthier and don't use a lot of health care. That could be a real problem if you're chronically ill.\"\u003c/p>\n\u003cfigure id=\"attachment_82031\" class=\"wp-caption aligncenter\" style=\"max-width: 765px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/09/Screen-Shot-2015-09-22-at-10.02.43-AM.png\">\u003cimg class=\"wp-image-82031 size-full\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/09/Screen-Shot-2015-09-22-at-10.02.43-AM.png\" alt=\"Worker contributions to health insurance have increased 83 percent in 10 years. \" width=\"765\" height=\"634\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2015/09/Screen-Shot-2015-09-22-at-10.02.43-AM.png 765w, https://ww2.kqed.org/app/uploads/sites/27/2015/09/Screen-Shot-2015-09-22-at-10.02.43-AM-400x332.png 400w\" sizes=\"(max-width: 765px) 100vw, 765px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Worker contributions to health insurance have increased 83 percent in 10 years.\u003c/figcaption>\u003c/figure>\n\u003cp>Employer-sponsored health insurance is the most common form of coverage in the United States, with about 147 million people enrolled. Companies of all sizes offer coverage as a way to keep workers and make sure they stay healthy. But years of rising costs have forced many businesses to scale back their coverage. One of the quickest ways they have to control the growth in premiums, or cost of coverage, without significantly changing the insurance is to raise an employee's deductible.\u003c/p>\n\u003cp>Altman said the increase in deductibles has helped restrain premium growth for the past several years. In 2015, premiums rose an average of 4 percent for single and family coverage.\u003c/p>\n\u003cp>The employer generally pays most of the premium and has the remaining share taken out of the employee's paycheck before taxes.\u003c/p>\n\u003cp>Kaiser's research found that the size of a health plan's deductible can depend on the employer. Small firms had an average of $1,836, while big businesses had $1,105. Many companies pair that coverage with accounts that let employees set aside money before taxes for medical expenses.\u003c/p>\n\u003cp>Commercial painting company Steve Reiff Inc. offers single coverage with a deductible of $5,950. The South Whitley, Indiana, company also helps cover about half the cost of that deductible with contributions to an employee health reimbursement arrangement account, Controller Eric Trump said.\u003c/p>\n\u003cp>The business switched to a high-deductible plan several years ago to help restrain premium growth. That move helped, but Trump worries about leaving roughly 30 people on their coverage with the high deductible.\u003c/p>\n\u003cp>\"It's really hard to like a lot of health insurance options right now,\" he said. \"It's still a big expense for people that are making $10 to $15 an hour.\"\u003c/p>\n\u003cp>Paducah, Kentucky, resident Emmett Krall says the annual deductible of $3,500 on his employer-sponsored health insurance makes him think about cost more than he wants to, especially since his 10-year-old son was diagnosed with Type 1 diabetes last year.\u003c/p>\n\u003cp>Krall said he has to come up with about $200 a month to cover his son's insulin, needles and pump. The 46-year-old carpet manufacturer sales representative said he has cut down on going out to eat, and he's watching where he spends his money.\u003c/p>\n\u003cp>\"It causes an anxiety and a stress on my part, because I do get stressed about it, and I don't want him to know about it,\" he said.\u003c/p>\n\u003cp>College professor Bill Cantor said he's seen his premium fall to only $95 a month for family coverage from around $300 since he switched to a high-deductible health plan a few years ago. He uses a health savings account to set aside money for expenses, and he likes how the plan has made him more aware of costs.\u003c/p>\n\u003cp>The 53-year-old said he caught a $200 mistake on a medical bill that he might have missed if insurance had just covered the claim.\u003c/p>\n\u003cp>\"I think it would hold down insurance rates more if people thought about their spending,\" said Cantor, who teaches information science and technology at Penn State's York, Pennsylvania, campus.\u003c/p>\n\u003cp>Kaiser's survey focused on benefits for this year and doesn't predict what will happen in 2016, something many workers will learn about in a couple of months when their employers detail coverage plans for the new year.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Kaiser Vice President Gary Claxton said he doesn't expect the trend toward higher deductibles to ease much in 2016. He noted that employers tend to make their coverage more generous as the economy improves. But companies still will be intent on controlling costs to prepare for an overhaul-imposed tax on expensive benefit plans that starts in 2018.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/82029/employers-continue-to-shift-health-costs-to-workers-survey-finds","authors":["byline_stateofhealth_82029"],"categories":["stateofhealth_2442"],"tags":["stateofhealth_799"],"featImg":"stateofhealth_82056","label":"stateofhealth"}},"programsReducer":{"possible":{"id":"possible","title":"Possible","info":"Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. 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