The obscure, seemingly random universe of health-care pricing is getting a little less opaque today. Some of the country's largest health insurers are coming together to reveal the prices they pay for dozens of medical services across the country in an effort to help consumers become savvier shoppers.
All the information can be found at Guroo.com, a site launched Wednesday morning that was built by a health-care nonprofit group with information from United Healthcare, Humana, Aetna and Assurant Health. The transparency effort is a nod to the growing trend of patients being asked to pay more out of their own pockets, as insurers try to manage their costs and steer customers toward preferred health-care providers.
"The rise in health-care spending underscores the need to make it more transparent and help consumers make more informed decisions regarding their care," said David Newman, executive director of the Health Care Cost Institute, which built the Web site.
Guroo's initial rollout will let patients compare costs for more than 70 common services, which includes things as simple as a doctor's visit, or something more complex like a knee surgery. These are prices for health-care services that patients may shop for ahead of time, as opposed to the cost of emergency room care.
Anyone can use the site without charge to get a better idea of the baseline prices for health-care services in their area, based on the actual prices that these insurers pay to providers. Guroo's data won't tell the whole story for patient costs, though. The site doesn't break down what a consumer pays for services versus what the insurer pays. It's better to think of the price platform as more of a guide, Newman said.
As previous data have shown, prices for the same medical service vary widely across the country, even within the same city. In Dallas, for example, a knee surgery will run anywhere between $16,772 and $61,585 depending on the hospital. And in health care, there's little relationship between price and quality of services.
Patients already have price transparency tools to choose from, with most health insurers offering their own platform for their customers. The difference with Guroo is that there's more data across different insurers compiled in one place.
"It's data that no one else has," Newman said.
The site lets patients search by condition. So, if you're going in for total knee replacement surgery, for example, you type that into Guroo's homepage. Once you've clicked through a couple of options to narrow down your search, the site shows you the services you could expect: an office visit with a specialist, the surgery itself, physical therapy and follow-up office visits. You can either view the average price for your area, or a range of prices. The search results look like this:
So, it gives you an idea of prices, but again, not necessarily what you'll actually pay through your insurance. Still, the prices may be most useful for the estimated 30 million people still lacking insurance, or those who haven't met their health plan's deductible.
But past surveys show that patients really aren't making use of these transparency tools. When they do, though, it seems some services are more worth the shopping effort than others. In one study of pricing transparency software last year, patients on average could save $125, or 13 percent, on advanced imaging tests by making the effort to shop around. But for a clinician office visit, patients only found about a dollar's worth of savings.
The Guroo data, in some spots, are still incomplete. The platform doesn't have robust enough information for eight states or some parts of California, Newman said. HCCI has data for another 215 episodes of care that could be part of future data releases.
Later updates, Newman said, will incorporate government claims data. There will also be a more concentrated effort to link price and quality information to give patients a more complete look at the value of care. And patients covered by the insurers participating in the claims database will eventually get a personal account that will provide more personalized information based on their health plan's benefits and provider network.
Industry reaction has been mixed since the initiative was announced last May, Newman said. "There are some [medical providers] who’ve said this is really going to affect our bottom line and be really difficult for us to deal with," he said.