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Elusive Goal: A Transparent Price List For Health Care

Health care goes mobile with apps, devices

Since doctors and hospitals generally don’t tell people how much services cost beforehand, the best way to figure out the price is to get receipts from the parties that pay the bills: insurance companies, Medicaid and Medicare, mostly. The more such information is made public, Sonn says, the more people will “vote with their feet” and migrate away from high-cost providers. However, turning this information about price from eye-crossing rows in a spreadsheet into consumer-friendly formats is hard. Colorado’s effort has taken years. Laws had to be passed to get insurance companies to send in their claims data (the receipts for what they’re paying), and sorting through all the information is a lot tougher than organizing a pile of paper receipts in a shoebox. “Claims data is dirty,” says Sonn. “It’s really dirty. It takes a lot of scrubbing to make sense of it. It’s complicated, time consuming and expensive.” Before The Prescription, Ask About Your Doctor’s Finances Colorado has had funding to do that from private grants, but those are drying up. In order to keep on making basic price information accessible to the public for free, the state wants to sell more complicated, custom data reports to businesses within the health industry. There is a growing market for those sorts of reports, says Dr. David Ehrenberger , the chief medical officer for Avista Adventist hospital, outside Denver. He would like to see reports that show not just how much his competitors are charging, but also whether their patients have more or fewer complications.

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Health Plans Must Cover Suicide Related Costs, But Many Refuse


Further, the 2006 regulations make clear that such source-of-injury exclusions cannot be imposed even if the mental health condition is not diagnosed before the injury, said a spokesperson for the Department of Labor in an email. When a 24-year-old young woman with bipolar disorder attempted suicide last year by taking an overdose of an anti-anxiety medication, her mother assumed that the mothers employer plan coveringthem both would pay the bills for her daughters emergency room visit and her three days in the hospital near her Fort Wayne, Ind., home. But the insurer declined to pay the $6,600 hospital charge, citing an exclusion for care related to suicide. I knew I could appeal the decision, but I didnt think I had any grounds to do so, the mother says. I thought thats just the way it was. After negotiating with the hospital, the bill was reduced by half and her daughter has been paying the balance off in installments, she says. Suicide is a common exclusion, says Sara Rosenbaum, a professor of health policy at George Washington University. Insurers are all over the place on this, and state law varies tremendously. In court cases arising from a denial of benefits, if the suicide attempt is related to a diagnosis that was treated, typically [the courts] will not deny coverage, says Ann Doucette, a George Washington University professor of arts and sciences whos involved in research related to suicide. Still the insurance industry says the issue has not raised major concerns. Its not something weve been hearing about, says Susan Pisano, a spokesperson for Americas Health Insurance Plans, a trade group. Roughly 38,000 people commit suicide annually, according to the National Institute of Mental Health. More than 90 percent of people who die by suicide bhave a mental health condition, says Jennifer Mathis, director of programs at the Judge David L. Bazelon Center for Mental Health Law. Depression, bipolar disorder and schizophrenia are mental illnesses commonly associated with suicide. The HIPAA nondiscrimination rules apply to all employment-based health insurance. The health law extended thoserules to the individual insurance market, including plans sold on and off the health insurance marketplaces. All individual market plans must cover mental health and substance use disorder services as well.

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Some states are trying to make health care prices available to the public by collecting receipts from those who pay the bills: Medicare, Medicaid and private insurers. Some states

“Mobile apps are one of many mHealth tools that are helping to engage consumers and patients in their own health care,” David Collins, senior director of the mobile division at the non-profit Healthcare Information and Management Systems Society, told AFP. Slashing health care costs Doctors and developers alike are hoping that these mobile apps and devices will lead to lower health care costs. Health care businesses such as hospitals and insurance companies traditionally focus on quantity, counting the number of patients seen and procedures done. But as the system shifts and firms try to quantify the quality of care, factors such as whether a patient returns to the hospital within 30 days of treatment come into play, and can affect insurance payouts for care. The idea is that if patients track their own health, using mobile apps and other tools, the extra data can reduce the numbers of doctor’s visits, and make each one more effective. The Scripps Translational Science Institute in California is in the middle of a study examining the relationship between medical costs and mobile medical devices, specifically in patients with chronic conditions. Participants receive an iPhone and either a blood pressure monitor, heart monitor, or glucose meter to track their high blood pressure, arrhythmia, or diabetes for six months. Lead researcher Cinnamon Bloss said the team will be looking to see if by monitoring their own symptoms, patients can avoid unnecessary trips to the doctor or emergency room, as Fox has. Patient compliance not easy A few months into the study, Bloss has already noticed one longstanding problem that persists despite the ease of using mobile apps — patient compliance. “We’re offering a free phone and device for a disease they already have, but many people don’t want to be bothered, don’t want to take the time,” Bloss said. And according to Iltifat Husain, the founder of the app review website, a lack of adherence to treatment plans can have significant financial and health-related consequences. “Patients who are non-compliant end up costing us billions of dollars in the health care system. I see it on a daily basis,” he said at an event at the Brookings Institution in Washington.

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This entry was posted on February 20, 2014 by .
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