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February 12, 2013 | 1:33 PM |

Study: Hard To Shop For Hip Surgery, Even With $100K At Stake

(pasm/ Wikimedia Commons)

(pasm/ Wikimedia Commons)


As WBUR’s Martha Bebinger has reported repeatedly, it is hard, hard, hard to compare the price tags on medical procedures — even though the out-of-pocket costs to you could vary dramatically depending on where you get your care.

Now a new study in the journal JAMA Internal Medicine pins down this shopping problem for one particular procedure: elective hip surgery called total hip arthroplasty, or THA.

The researchers called hospitals around the country — and called and called and called, up to five times each — in search of the institution’s lowest price for a 62-year-old grandmother who lacked health insurance but could pay out of pocket. From the paper’s abstract:

Results Nine top-ranked hospitals (45%) and 10 non–top-ranked hospitals (10%) were able to provide a complete bundled price (P < .001). We were able to obtain a complete price estimate from an additional 3 top-ranked hospitals (15%) and 54 non–top-ranked hospitals (53%) (P = .002) by contacting the hospital and physician separately. The range of complete prices was wide for both top-ranked ($12 500-$105 000) and non–top-ranked hospitals ($11 100-$125 798).

Conclusions and Relevance We found it difficult to obtain price information for THA and observed wide variation in the prices that were quoted. Many health care providers cannot provide reasonable price estimates. Patients seeking elective THA may find considerable price savings through comparison shopping.

Oh, except, wait a minute, you can’t comparison shop very well when more than half of hospitals can’t give you their prices.

The latest health reform law in Massachusetts, passed last year, is supposed to address this problem and require greater price transparency from hospitals. Will it? Meanwhile, my friend Jeanne Pinder’s ClearHealthCosts.com uses crowdsourcing to help consumers help each other gather cost data. She blogs about the new study:

This is one of our favorite topics. If you haven’t recently, go to our PriceMap interactive page and play around with the search; for a range of procedures, in cities all over the United States, we show you what the government is paying via Medicare, the program for the elderly and disabled. You’ll be shocked at the range.

FILED UNDER: Insurance, Podcasts, costs of care
January 2, 2013 | 11:20 AM |

Study Finds ‘Protective’ Weight Just As Diet Resolutions Kick In

obesekid
Whoopsie. Just as all those New Year’s dieting resolutions are kicking in, along comes the latest salvo in the confusing obesity-mortality wars. “Oh, my,” I said this morning when I heard Harvard nutrition expert Walt Willett call this latest study a bunch of “rubbish” on NPR. “They’re playing rough.”

At issue is this simple question: Does being overweight make you die sooner, or might it actually be protective? But of course, very little is simple in the world of nutrition studies, or when links between Body Mass Index and health are concerned.  Here’s the conclusion from the study, that in effect, very obese people tend to die earlier, but more mildly overweight people may tend to live a bit longer:

Relative to normal weight, both obesity (all grades) and grades 2 and 3 obesity were associated with significantly higher all-cause mortality. Grade 1 obesity overall was not associated with higher mortality, and overweight was associated with significantly lower all-cause mortality. The use of predefined standard BMI groupings can facilitate between-study comparisons.

And here’s Walt Willett on NPR today: Continue reading →

FILED UNDER: Insurance, Podcasts, CDC, nutrition, obesity
November 20, 2012 | 10:23 AM |

A Must-Read On Health Insurance If You’re Traveling Abroad

(Kuster & Wildhaber Photography/flickr)

Many of us — for better or worse — are traveling in the coming weeks or months. And if you’ve ever had to bring a sick child to a health clinic in a country where you don’t speak the language, you know how harrowing getting medical care while on “vacation” can be. (Not to mention the sticker shock when you get the bill.) Here’s a really helpful post on Healthcare Savvy by Sue (Sunni) Patterson that offers everything you’ll need to know about health insurance coverage if you’re out of the U.S. The bottom line: plan ahead as best you can.

You may be closing out 2011 with a holiday trip, domestically or internationally. If you plan to leave the country, you may want to consider the following when it comes to your health:

You may not have health insurance coverage for illnesses or injuries that are treated abroad, even if you have U.S. based medical coverage. Confirm with your benefits administrator.

Generally, Medicare does not provide coverage for hospital or medical costs incurred abroad, however, rare circumstances may be covered.

AARP can assist with obtaining foreign medical coverage and offers valuable travel tips.

U.S. consulate personnel will help you locate health care providers and facilities and even contact family members, if necessary.
You can purchase travel insurance that covers health care needs and pays for medical evacuation if you need to be transported back to the US for treatment.

Obtaining medical treatment in another country can be expensive and a medical evacuation can cost over $50,000. Plus, you may encounter challenges with deciphering charges while abroad. Be vigilant, prepared, and follow the same self-advocacy steps you would while receiving medical care in your home state.

If you choose to purchase medical expense coverage while traveling abroad, double check you’ve carefully researched the following:

–Trip cancellation clauses or reasons. You may want to choose an optional ‘cancel for any reason rider’.
–Inclusion of a waiver to a pre-existing condition exclusion.
–Plan coverage exclusions, situations and conditions.
–Save all receipts and document everything from the start of a condition; contact your plan representative immediately.
–Does the policy include medical evacuation coverage? If not, you may want to consider purchasing this optional coverage.
–Purchase travel insurance at the same time you pay for your trip. It’s too late after you’ve had an accident or become sick.

For more information about international travel preparation, visit the U.S. Department of State website.

FILED UNDER: Insurance, Medicine/Science, Podcasts, travel
December 2, 2011 | 8:37 AM |

Physician’s Group Denounces IOM On Health Coverage, Says Financial Conflicts Abound

Physician’s For A National Health Program, a group that advocates a single-payer health system, yesterday charged that the influential Institute of Medicine’s recommendations for “essential” health coverage under the new national health law are “skimpy” and biased and could “cause much suffering” for patients.

In response to the accusations, detailed in a letter sent to U.S. Health and Human Services Secretary Kathleen Sebelius, a spokesperson for the IOM, Christine Stencel, wrote this in an email message:

The committee’s report lays out the solid rationale for each of its recommendations and speaks for itself. We invite all interested people to download a free electronic copy and read it to see exactly what it said in terms of balancing coverage and cost.

Here’s the full news release from the national physician’s group:

More than 2,400 doctors, nurses and health advocates denounce Institute of Medicine’s health coverage recommendations

IOM panel ‘riddled with conflicts of interest’ in violation of agency’s own guidelines, signers of protest letter charge

In a letter sent to Secretary of Health and Human Services Kathleen Sebelius and posted on the Internet today, more than 2,400 physicians, nurses and other health advocates condemn the recommendations of an Institute of Medicine (IOM) committee regarding the “essential benefits” to be mandated under the 2010 federal health reform law. Continue reading →

FILED UNDER: Insurance, Medicine/Science, Money, Podcasts, benefits, institute of medicine, single-payer
May 13, 2011 | 12:52 PM |

Podcast Friday: Sex After Cancer, New Cystic Fibrosis Drug

In this week’s podcast, audio versions of two recent CommonHealth hits:

  • Sex After Cancer: Among the nearly 12 million cancer survivors in the U.S., many suffer from sexual problems related to their cancer of the treatment to fight it. Rachel Zimmerman details the problems, talks to patients and tracks one psychologist’s efforts to bring pleasure back to patients.
  • New Drug For Cystic Fibrosis: A still-experimental drug, called VX-770, while not a cure, is being called a “major advance” in CF research. VX-770 attacks the basic defect in cystic fibrosis, and right now helps only 4 percent of those living with cystic fibrosis. Carey Goldberg explains what VX-770 does, and how it’s helped one woman do things she’s never done before — like shovel snow.
    • CommonHealth Podcast: May 13, 2011
    FILED UNDER: Personal Health, Podcasts, below the waist, cancer, cystic fibrosis
    March 11, 2011 | 12:03 PM |

    Podcast Friday: Storytelling As Patient Therapy; ‘Better Care, Cheaper’ Experiment

    Our podcast this week features an interview with Dr. Annie Brewster, a Boston internist who became interested in storytelling as a kind of therapy for patients, and a Massachusetts General Hospital program that saves money while also giving better care to chronically ill older patients.

    • A recent study published in The New York Times found that patients listening to other patients telling their own stories can be therapeutic. We spoke to Annie Brewster, a doctor living with multiple sclerosis, about her project documenting the lives of patients and their families in the midst of serious illness.

      • (Check out Dr. Brewster’s “Listening Project,” here, here and here.)

    • Is Better Care Cheaper? Older patients with multiple chronic diseases are the biggest consumers of health care. We explore how the next phase of Gov. Deval Patrick’s health care plan aims to cut this cost down, and hear one doctor’s perspective about whether it will actually work.
    CommonHealth Podcast: March 11, 2011
    FILED UNDER: Personal Health, Podcasts, Politics, annie brewster, listening to patients, Massachusetts General Hospital, storytelling
    February 25, 2011 | 9:01 AM |

    Podcast Friday: Patrick’s Health Care Overhaul, Bright Spots In Stroke Research

    Yep, it’s about that time…Podcast Friday! This week we have two big stories:

    • Reform 2011: Gov. Deval Patrick announced his plan to overhaul the Massachusetts health care system. He’s proposing going from a system that rewards doctors based on the quantity of services to one that emphasizes quality and integrated care. But will his proposal actually work? We look into it.
    • 10 Steps Forward On Stroke Research: For Carey, the issue of stroke is personal (read her story here). But it also affects an astounding number of people. Stroke is the second-biggest killer worldwide, and the biggest disabler of American adults. Yet the progress in stroke research seems to be slim. We discuss 10 relatively bright spots and what they mean for stroke survivors.
    CommonHealth Podcast: Feb. 25, 2001
    FILED UNDER: Personal Health, Podcasts, Politics