New Tool Helps Healthcare Consumers

California’s HealthCare Foundation releases an update to its searchable map allowing residents and doctors to search and compare the frequency of more procedures in communities throughout the state

When you go to a doctor you likely don’t know that you don’t always have to do as he says. Sometimes medical recommendations don’t come with all the options clearly outlined for you. 

Now comes a computer tool to help you make more informed choices about your healthcare.
California’s HealthCare Foundation has released an update to its “All Over the Map” interactive computer tool that tracks geographic variations in common medical procedures in communities throughout the state.
Now patients and doctors will be able to not only compare the frequency of procedures such as heart surgery, childbirth, and joint replacement but also spine procedures, breast cancer treatment and prostate cancer screening and treatment.
By comparing one community to another, patients and doctors will be able to make more informed decisions about their individual cases and treatment choices.
This follows NBC Bay Area’s investigation which uncovered the wide disparity in healthcare costs among area hospitals back in February 2013.
Under California’s Payer Bill of Rights hospitals report to the state how much they charge for common medical procedures and treatments; everything from gauze to medication to surgery.
Using that data, NBC Bay Area’s Investigative Unit tracked how much it might cost you to do everything from a chest x-ray to an emergency room visit to a colonoscopy.
The data from the state showed wide discrepancies in costs covering 44 different common hospital procedures.
“It does not mean that a high-priced hospital is providing better service,” Dr. Renee Hsia, emergency room physician at San Francisco General Hospital and researcher at the UCSF School of Medicine, said.
For example, according to data reported by hospitals, a two-view chest x-ray (CPT Code: 71020) is estimated to cost $1,908 at North Bay Medical Center. That is 19 times higher than the least expensive cost estimate of $98 at Santa Clara Valley Medical Center.
A level 4 emergency room visit (CPT Code: 99284) is estimated to cost $7,328 at Stanford Medical Center, which is $6,764 more expensive than the least expensive cost estimate on the list--$564 at Alameda County Medical Center.
The estimated cost for diagnostic colonoscopy (CPT Code: 453787) at Marin General Hospital is $9,655. That is $4,966 higher than the average of the other 43 hospitals. 
Several hospitals told NBC Bay Area that their cost estimates for these procedures could include different kinds of associated care, such as supplies and medications and that could account for the variation in price for the same listed procedure among hospitals. They also agreed that there is no real way for consumers to know how much they are paying for their care up front.
Consumer advocates say that makes healthcare choices even more confusing for those who need to make those choices.
“I’m not sure how much people understand how much variation exists both in how much things costs but also what kind of treatment options are available to you,” Maribeth Shannon, who serves as Market and Policy Monitor Director at California HealthCare Foundation, said.
“I think some people would be surprised to know that there isn’t regulation of what hospitals charge,” Dr. Hsia said. “They are free to charge whatever they want based on what they feel their costs are.”
California’s HealthCare Foundation tool also shows that there are also wide discrepancies in the type and frequency of surgeries, procedures and other courses of treatment depending on where you live.
“By using transparency we really think people will have more information so that they can make better healthcare choices,” Shannon said. “It would be fascinating, I think, for people to go around and look and see how much variation exists for different kinds of procedures.”
The tool, developed in conjunction with researchers at Stanford University, allows patients and doctors to compare the frequency of different procedures with other communities and the statewide average for that procedure.
“Through this map we’re hoping to both reach consumers and doctors,” Shannon said.
This interactive computer tool was first released in 2011, but it’s now been updated to include data on breast cancer treatment options, as well as spine surgery frequencies and prostate cancer treatment options.
The tool has been adjusted for population, ethnicity, age and insurance coverage levels to make it more accurate.
California’s HealthCare Foundation also released a piece about residents in Humboldt County who used this data to improve and better inform their healthcare choices.
“I think it’s interesting to kind of look around the state and see what most people in particular areas seem to be having recommended by their doctors,” Shannon said. “And it is important to understand that they have options that they should talk about with their doctors. So why are people in Humboldt County getting a certain breast cancer treatment when people with the very same stage of illness seem to be getting different kinds of treatment?”
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