Patient Compares Test Costs

Thanks Patti Sills for the following editorial in the Vail Daily on April 10 2012. It's important for patients to be active in deciding where to get their care and we are very proud that Vail Valley Medical Center is so competitively priced!

When was the last time you bought a car without even looking at the price tag? Or signed a mortgage having never looked at the house or the cost? Never.

But for most Americans that's exactly what we do each time we walk into a doctor's office for a routine checkup go to the hospital for a minor procedure or major surgery or have blood work drawn and analyzed.

Americans spent $2.6 trillion on health care in 2010 yet we haven't the faintest idea what any treatment costs at the point of service or how it compares with the same treatment elsewhere.

However prices vary wildly and seemingly without reason even here in our own backyard.

For 15 years I am twice yearly required to submit to a number of blood tests to monitor my hypothyroidism. In June 2011 my primary-care physician ordered a series of routine blood tests and I requested a full thyroid panel be done which is customary for me once a year. Considered preventative medicine these five thyroid tests cost about $400 and are covered by my insurance.

A month later I received a bill for labs conducted by Valley View Hospital in Glenwood Springs for a whopping $1434 with absolutely no breakdown of costs. Nearly a year later after numerous phone calls to my primary-care physician Valley View Hospital and my insurance company I am only now getting to the bottom of the charges.

During that time I received a letter from Valley View Hospital stating "Valley View Hospital is trying to be competitive in their pricing. Valley View Hospital staffs the lab 24 hours and is able to process 95 percent of procedures on site and this is why some of the charges for lab procedures are higher."

Never before had these tests cost so much. Curious about Valley View Hospital's reasoning for its higher prices I made phone calls to three of its competitors. Here are the results.

T4 (Thyroxine Total): Vail Valley Medical Center $60 Aspen Valley Hospital $71 St. Mary's Grand Junction $50 Valley View Hospital $136.

T4 Free: Vail Valley Medical Center $68 Aspen Valley Hospital $93 St. Mary's Grand Junction $87 Valley View Hospital $310.

T3U (Thyroid Hormone Uptake): Vail Valley Medical Center $71 Aspen Valley Hospital $67 St. Mary's Grand Junction $56 Valley View Hospital $95.

T3 Free: Vail Valley Medical Center $79 Aspen Valley Hospital $145 St. Mary's Grand Junction $185 Valley View Hospital $153.

TSH (Thyroid Stimulating Hormone): Vail Valley Medical Center $73 Aspen Valley Hospital $172 St. Mary's Grand Junction $42 Valley View Hospital $227.

Total: Vail Valley Medical Center $351 Aspen Valley Hospital $548 St. Mary's Grand Junction $420 Valley View Hospital $921.

Note: Prices are current as of January 2012. Each competing lab confirmed 24/7 staffing and conducting the majority of tests in-house.

I know I will not likely work with Valley View Hospital in the future at least not knowingly and without doing my research first.

The experience while costly taught me a lot about our fragmented health care system how little patients or providers know about the real cost of health care and how hard it is for patients to make price-based decisions when the system isn't designed with that in mind. And most people don't have the time connections or industry knowledge to pursue this.

In the past there's been little incentive for physicians and hospitals to provide cost information because insurance was picking up the tab. But with growing out-of-pocket expenses the time is ripe for a transparent consumer-driven health care system.

In my research I discovered several new easy-to-use websites that can help you make informed health care decisions as well as contribute to the bettering of the system because if no one challenges the status quo we can expect more of the same.

Outofpocket.com was created to educate consumers about true health care prices. This website allows you to search for prices for health care services and allows you to post prices you paid for health care services.

Healthcarebluebook.com was developed by a physician whose son has cerebral palsy and also grew weary of lack of cost transparency for health care. Like outofpocket.com it is a free consumer guide to help you determine fair prices in your area for health care services and allows you to post your costs for health care services.

It also provides employers with analytics to help them understand their provider network costs and comprehensive programs to support employers with high-deductible health plans consumer-directed health plans and reference pricing.

Simplee.com is a new web-based service that can help you get control of your health care costs and expenses. Like Mint.com with your personal finance accounts Simplee safely and securely links to your health insurance and transforms it into a clean easy-to-read dashboard for tracking and controlling spending reducing paperwork expanding health care options and saving money.

Webmd.com Health Insurance Negotiator is written by Lisa Zamosky a journalist whose work has appeared in the Los Angeles Times MSNBC.com Kaiser Health News the Chicago Tribune Baltimore Sun Prevention and iVillage.com among others. She writes about health insurance the business of health care a wide range of consumer health topics fitness nutrition and biopharmaceuticals.

Patti Sills
Avon