Imagine going to the grocery store, picking up the items you need for the week, but not knowing how much anything costs until the store sends you a bill two weeks later.
Sadly, that’s how our healthcare system works every day.
Healthcare costs now represent one in every five dollars spent in our country. Patients’ deductibles and copays are rising. Prescription drugs are often unaffordable for many Americans.
We must do something about rising costs, and one key is to empower patients with the information they need to drive costs down and quality up by making the healthcare system compete for their business.
That’s why Medicare recently launched a new online tool that allows consumers to compare Medicare payments and patient copayments for certain surgical procedures that are performed in both hospital outpatient departments and ambulatory surgical centers.
The Procedure Price Lookup tool displays national averages for the amount Medicare pays the hospital or ambulatory surgical center. It also shows the national average copayment amount a beneficiary with no Medicare supplemental insurance would pay the provider.
Working with their doctors, people with Medicare can use the Procedure Price Lookup to consider potential cost differences when choosing among safe and clinically appropriate settings to get the care that best meets their needs. And cost differences can be substantial.
The lookup tool is needed because the law requires Medicare to maintain separate payment systems for different types of healthcare providers. That means Medicare pays sharply different amounts for the same service, depending on the locale of the care. It also means that people with Medicare pay different co-pays for the same service, depending on where it’s delivered.
Unfortunately, this is a prime example of Medicare’s misaligned financial incentives, under which providers can make more money if they treat patients at one location as opposed to another. Here’s an example: a Medicare beneficiary needs knee surgery, and her surgeon offers her the choice to have the surgery in the local hospital’s outpatient department or at an independent surgery center.
With the Procedure Price Lookup tool, the beneficiary can type in the type of surgery and see an estimate of the difference in out-of-pocket costs between the two settings.
It would take an act of Congress to change Medicare’s payment systems. In the meantime, patients have the right to at least know what they will be charged. The Procedure Price Lookup makes that information easy to access.
Procedure Price Lookup is part of our eMedicare initiative and joins other patient-oriented transparency tools, including an overhauled version of our drug pricing and spending dashboards. These new tools provide patients with Medicare and Medicaid spending information for thousands more drugs than ever before and, for the first time, list the prescription drug manufacturers that were responsible for price increases.
We launched the eMedicare initiative to empower beneficiaries with cost and quality information. eMedicare also offers a mobile-optimized out-of-pocket cost calculator to provide beneficiaries with information on overall health plan costs and prescription drug costs.
The case for price transparency throughout the healthcare system is clear. The need for consumers to comparison-shop is growing as high-deductible plans become the norm. We also need to integrate quality information with price transparency, so consumers are empowered to seek out high-value care among providers competing on both cost and quality.
Greg Dill is Medicare’s regional administrator for Arizona, California, Nevada, Hawaii, and the Pacific Territories. You can always get answers to your Medicare questions by calling 1-800-MEDICARE (1-800-633-4227).
COMMENT POLICY: We welcome comments from individuals and businesses. All comments are moderated. Comments are subject to rejection if they are vulgar, combative, or in poor taste.
REAL NAMES ONLY: All posters must use their real individual or business name. This applies equally to Twitter account holders who use a nickname.
All opinions and ideas are welcome. Factually inaccurate, libelous, defamatory, profane or hateful statements are not.
Your words must be your own. All commentary is subject to editing for legibility. There is no length limit, but the shorter,
the better the odds of people reading it. "Local" SCV-related topics are preferred. Send commentary to: LETTERS (at) SCVNEWS.COM. Author's full name, community name, phone number and e-mail address are required. Phone numbers and e-mail addresses are not published except at author's request. Acknowledgment of submission does not guarantee publication.
As restrictions remain in place for gatherings and events in Los Angeles County, one of Santa Clarita’s most important traditions will take place on an online format in 2020.
The holiday shopping rush is upon us! As with everything this year, checking loved ones off your shopping list will look a little different in 2020. There will be no braving the crowds and tussling for the first crack at the doorbuster deals on Black Friday.
In his monthly message for October 2020, Santa Clarita City Manager Ken Striplin spotlights results of the city's 2020 public opinion survey about the quality of life in our community.
As with everything in 2020, this year’s State of the City event will be different than years past. We are looking on the bright side, embracing the necessary changes for safety’s sake and rejoicing in the fact that this year’s event is truly inclusive of the entire Santa Clarita community.
The COVID-19 crisis has trashed recycling efforts and instead generated an increase in plastic waste, according to a recent study, but Los Angeles County restaurants could soon be required to make adjustments related to disposable food ware in an effort to reduce waste.
Despite signs that California’s latest and most damaging wave of the pandemic is subsiding, the state nonetheless sets a one-day record of 764 deaths on Friday.
Claims of excessive force, retaliation, and other misconduct by the Los Angeles County Sheriff’s Department will be probed during a C, California Attorney General Xavier Becerra said Friday.
Los Angeles County Department of Public Health officials on Friday confirmed 256 new deaths and 9,277 new cases of confirmed COVID-19 countywide, as Henry Mayo Newhall Hospital in Valencia reported it's 107th death.
The Los Angeles County Library, in collaboration with the Los Angeles County Museum of Art, is set to host a series of free virtual workshops running every other week on Fridays from January through June.
The temporary residential green waste pick-up schedule will continue through Jan. 29 for customers in Santa Clarita after Waste Management requested an additional week for its modified schedule.
The William S. Hart Union High School District Governing Board has approved the recommendation to name Julian Gomez as the assistant principal of Bowman High School.
The Los Angeles County Development Authority will launch the Small Business Stabilization Loan Program on Jan. 28 and will begin accepting applications to help small businesses prevent further job loss and business closures.
The William S. Hart Union High School District governing board voted 3-1 Wednesday night to let athletic conditioning return to district campuses Jan. 27.
Join the Santa Clarita Valley Water Agency (SCV Water) on Thursday, Jan. 28, from 6:30 p.m. - 8:00 p.m., to learn about and provide input on its Water Shortage Contingency Plan (WSCP).
The Los Angeles County Department of Public Health confirmed 262 new deaths, including an additional death at Henry Mayo Newhall Hospital, and 8,512 new cases of confirmed COVID-19 countywide, with 22,360 total cases in the Santa Clarita Valley.
SACRAMENTO – California State Epidemiologist Dr. Erica Pan issued the following statement Thursday advising providers that they can immediately resume the administration of lot 41L20A of the Moderna COVID-19 vaccine, which was temporarily paused on Sunday due to possible allergic reactions.
Supervisor Kathryn Barger, whose 5th District includes the Santa Clarita Valley, is supporting the effort by the California Public Utilities Commission (CPUC) to address concerns of communities throughout Los Angeles County, which continue to experience ongoing Public Safety Power Shutoffs (PSPS) initiated by Southern California Edison (Edison).
Single Mothers Outreach (SMO) is proud to announce “Survivor” as the theme for the 11th annual Empowering HeArts fundraising gala set to take place virtually on Saturday, Aug. 7.
The College of the Canyons School of Personal and Professional Learning was presented an Honorable Mention award by the Academic Senate for California Community Colleges’ 2021 Exemplary Program Award.
The William S. Hart Union High School is looking for two new members to serve on the Measure SA Citizens’ Oversight Committee. These members will serve two-year terms with a maximum of three consecutive terms.
The Los Angeles County Coroner-Medical Examiner’s Office identified Carlos Salgado-Ruiz, 35, of Santa Clarita, as the pedestrian killed after being struck by a vehicle in Saugus Wednesday night.
REAL NAMES ONLY: All posters must use their real individual or business name. This applies equally to Twitter account holders who use a nickname.
1 Comment
Sick people shouldn’t have to play games to get treatment. Fix it.