Just had a great interview with some allies in the battle to bring transparency to the healthcare system. I spoke with Kristy Williams of Alijor and for those not familiar with them, the concept is interesting. On Alijor, patients can connect with providers to address their specific need(s). Simply opening a line of communication between provider and patient is a huge need.Alijor facilitates just that and more.

Right now, there is a lot of effort going into the effort to bring transparency to healthcare, and we’ve met a lot of them in the past two years of doing this. We’re going to meet more in the coming years, but it’s nice to find friends in among the fray who are thinking outside of the box and who share our goals.

We need all of the friends we can get. Thanks guys!

The Nashville Business Journal ran an article Friday about change:healthcare!!

With the book prominently featured, the NBJ says, “Nashville technology start-up change:healthcare has stepped into the national spotlight for its efforts to teach consumers how to shop for health care and decipher the language of  health care providers and insurance companies. The company released “My Healthcare Is Killing Me,” a free e-book for consumers overwhelmed by medical bills or in search of health care choices that benefit them.”

“One of the cornerstones of the consumer-based approach is “transparent” access to pricing from hospitals, doctors, insurance companies and other providers so that individuals can make informed choices about their care.”

Check out the full article by downloading the PDF here.

Christopher talks health care costs, the book, and transparency on Forbes.com!!

Check out the article on the web.

Or download the PDF.

Consumerism, just like transparency, is a current industry buzz word.  It is thrown around like everyone knows exactly what “healthcare consumerism” means.  However, consumerism often refers to the “derogatory” idea of society being preoccupied with the acquisition of consumer goods. Since healthcare consumerism is intended to represent a more positive movement, I am going to lay it all out on the table.

Consumerism, in relation to healthcare, is about moving past the perception that someone else is responsible to make decisions for us. We need to shift our thinking to be more actively engaged in our health and healthcare decisions.

Think about it - active participation and education prior to decision-making occurs in almost every other industry and consumer purchase… e.g. automobiles, electronics, home buying. Why are we so inclined to remain a bystander when it comes to healthcare? We need to move past the era of the passive patient.

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I can only imagine how many differing opinions there are about how to solve our healthcare crisis.  But how many opinions are out there about what is wrong with our healthcare system?  Dare I start a list…

Anyhow, in doing some recreational reading and email sorting this morning, I came across a link to an article (sent from a colleague) “Government Contemplates Financial Bailout While Taxpayers File Bankruptcy for Medical Bills – When Will Congress Intervene in Skyrocketing Healthcare Costs?”  Great title, right? As I read through the article I couldn’t help but wonder how many people think that our healthcare problem should be “solved” by our government. Yes, yes, please let the government solve our healthcare crisis (read: tax payers pay for it).

I do not have beef with the article, or with the government “solving” problems for that matter.  The piece is very well written and highlights the problems and costs Americans are facing in relation to their health expenses.

I guess my question lies in this last paragraph, “The unacceptable result of all this is that an increasing number of Americans are foregoing expensive but much-needed drugs and treatments, including those for serious conditions such as diabetes and high blood pressure, which if left untreated can result in worsening conditions, hospitalizations, or even death. The problems in our health care system need to be addressed by Congress now.”

Hmmmm, so what does Congress do… implement a mandatory exercise hour across America?

Our solution has to be a JOINT EFFORT.  This is not solely the government’s problem!!

Yes, a lot of this is their fault. However, I would argue that there are five major players in this mess, one of which is the government. (See my previous posts for the four contributors – since then I have added one). The other four: doctors, pharma (newly added), individuals, and insurance companies. Unfortunately, I have yet to appoint percentages of blame.

The majority of Americans know our system is failing, but are unwilling to make any sacrifices or changes. We have had a third party paying for our care for far to long, with ever increasing bottom lines and stricter rules for coverage. On top of that, the government cannot bail us out of our obesity (or sub other unhealthy behaviors) and sense of entitlement. Insurance companies sure aren’t going to help either.

There are three things that are going to help fix this system, and individual accountability is one of them.  We have to stop running to the doctor every time we have the sniffles. We must make health and wellness a priority – and start exercising.  Second, is transparency.  No one really knows what the true cost of healthcare is.  Guess what folks; an office visit does not cost $20.  To be accountable, cost and quality information must be available to consumers.  Last, is competition.  By being accountable for our decisions, and knowing the true cost and quality of healthcare, providers can begin to compete for our care. Until doctors/hospitals have to be accountable for the quality of care they provide and the amount they charge, nothing is going to change.  Every other market has competition, why should healthcare be any different.

Once again I had the privilege this morning to hear Sen. Bill Frist speak, this time at a breakfast held at Lipscomb University.  Though last time the topic was highly focus, today the slate was clear and anything to do with health care was on the table.  Although our time was limited, Frist managed to cover a lot of important topics and share his vast amount of experience and knowledge with us in the crowd.

The conversation began with a reminder that the US, compared to other countries, ranks poorly when it come to life expectancy and infant mortality, despite spending twice as much as other comparable countries.  Why is that?  Well consider what makes up health and life expectancy: 40% Life style and Behavior, 30% Genetics, 15% Socioeconomic status, 10% Health Services and Technology, 5% Environment.  Unless you have been living under a rock, its no shock…  we live in a country where our life style choices are not the greatest, a large portion of our country is obese and many people do not regularly exercise.  Add poor lifestyle choices to our lack of desire to change our behaviors, its no wonder we rank so low.

Anyways, from there we managed to discuss cost shifting, Medicare and the pending 10.6% reimbursement cut,  and the uninsured among other things.

My most important take away was his belief in consumerism and the public sectors ability to affect change.  In most all markets, with very few exceptions, competition and consumerism drive down or at the very least maintain costs.

Transparency… the new industry buzz word… connects right into this and refers to the idea that information regarding cost, quality, outcomes, and experience should be readily available to all consumers of healthcare (cost and quality being the top two, considering they are what we are having the hardest time controlling).

By making the industry more transparent, especially how much a physician is really being reimbursed for their services and how much a procedure will cost them before having it done, consumers have a better idea of the true cost and quality of the care they receive.

Wonder what the result is?? Well it’s believed that transparency in the industry will make consumers more inclined to take responsibility and accountability for their own health and health care. Now here’s the reality,  not everyone is going to care about how much their health care cost - Just like not everyone is going to care about “global warming”.

However the industry just really needs to see an emergence of “the prudent shopper”… the group of people that begin talk, begin taking note, and begin to care about their health care and its cost.

If you think you might be the next “prudent shopper” of health care, visit www.changehealthcare.com and see what you think… tell us what you think! We are moving into the world of transparency and engaging consumers… be part of that change.  That’s my advice.

Transparency, accountability, and competition… I must say - I am always happy to keep my feet moving, rather than be left behind.

Check out the Nashville Business Journal from Friday. Startup surfs transparency wave. Because you cannot read the whole article online… Click here to download the .pdf.

Highlights:

“The company has radically revamped its online Medstimate service, which discloses pricing for services from more than 1.5 million doctors and hospitals and price ranges for more than 10,000 medical services.”

“Customers can use Medstimate to reveal price transparency on everything from major surgery to a month’s supply of medication. For example, a Medstimate search shows price ranges at local hospitals for colon cancer treatment vary greatly, depending on the hospital. At Vanderbilt University Hospital, the range is $49,054 to $53,653. At Saint Thomas Hospital it’s $22,258 to $24,344.”

“Hendrick says he’s not trying to persuade consumers to always go for the least expensive alternative because there can be valid reasons for paying more. But the information derived from a Medstimate inquiry should help someone make a more informed health care decision, he adds.”

If you have ever wondered what would be a reasonable price for a medical service, you are not alone. Millions of Americans, especially those who are uninsured, walk into doctors offices every year with no idea of how much their care will cost. That’s a scary feeling, especially if you have to pay for all of it on your own, or if you are unsure how much of the costs your insurance company will cover.

How many people go to get their car repaired without knowing how much it will cost? Or without checking around for high quality, reasonably priced auto shops? I feel it’s safe to assume not very many. Why should our health care be any different? I would argue its more important than your auto repair.

A recent article in the Wall Street Journal by Dr. Benjamin Brewer, Even Doctors Guess At Health Charges, asks “Why can’t you find out how much medical care costs before you’re treated?” Weird thing is, he’s a doctor. Shouldn’t he know? Or at least have an idea of where to find some information on costs?

Well he doesn’t. And like countless other Americans, especially those striving to save money on high deductible plans or uninsured, he was in the dark about how much his daughter’s stitches (which were needed while on vacation) were going to cost at a near by hospital - how about $63.62 a stitch ($827 total)!!

I am in the same boat (no pun intended here)… I fell off a boat and went to the ER a few days later fearing a broken foot. I told the ER doc that I was on a high deductible health plan and did not want any unnecessary tests run. At the end of it all the doctor checked me out, did not feel that I even needed an xray, and sent me home with a prescription for pain medicine.

A few weeks later I got a bill for $604 from the hospital for my emergency room visit (billing code 99284). Then a week later another bill from the ER doc for about $260. My ER bill was negotiated down by my insurance carrier to $440, and my doctors bill down to $120 making my total out-of-pocket $600. That experience will certainly make me think twice about getting treated the next time I think I “broke” my foot. Also it made me wonder if my experience at one of the other 3 hospitals in my area, or even the acute care clinic, would have been less expensive. I should have done a little bit of research.

Hence why I am bringing our new MEDSTIMATE ratings to your attention. If our new Medstimates were up and running, I could have checked them out to see how much I could have expected to pay for my “broken” foot. Here is a more detailed example of how you can use the new Medstimate ratings: I could have looked up Vanderbilt, Saint Thomas, Centennial and even Baptist and found out how much I could have expected to pay at each hospital for my emergency room visit. Maybe at the end of the day I would have made the same decision, however I would have had a better idea of how much I may be asked to pay (and maybe kept my mouth from hitting the floor when I got the bill).

If you are uninsured the Medstimate can also be very helpful. Rather than paying full price for your medical services (no one on insurance pays full price… why should you?) you can look up the Medstimate for your particular services (or provider) and use it as a benchmark for negotiating your bill. You should never pay the full billed amount, and now the Medstimate provides you with an educated price range closer to what you should pay.

If anyone has any questions… doesn’t understand… it never hurts to ask. We have officially launched our Medstimate in relation to diagnosis and medical services will be coming in the next couple months… Hip Hip Hooray for TRANSPARENCY!!