Healthcare Savvy

Here at Aetna, we read with great interest, Martha Bebinger’s story chronicling her difficulties in finding the price of an MRI at different health care facilities in her area.  As Martha notes, it is difficult for consumers to “shop around” or make “wise choices” on health care decisions when they can’t find the price of a service.

We agree, and have been working to make that price information available for the last decade. Through free member tools like our Aetna Member Payment Estimator, we provide cost information for more than 550 commonly used, non-emergency medical services, including traditional or C-section births, colonoscopies, MRIs and CT scans. Members can compare up to 10 cost estimates at a time for the selected procedure in a geographic area, so they can see cost differences among different health care providers. Better still, the Member Payment Estimator gives members a personal picture of the costs by providing real-time out-of-pocket cost estimates based on a member’s benefits plan.

Our members use this tool more than 70,000 times per month, each keeping as much as $170 in their own pockets after comparing costs on more than 30 common procedures. In 2011, the U.S. Government Accountability Office recognized the Member Payment Estimator as the only tool from a private health insurance company that “provides estimates of a consumer’s complete cost.” Read the rest of this entry →

Caduceus
(via Wikipedia)

Look at the symbol in the header for Healthcare Savvy. An emblem of medicine and healthcare, right? Yes. No. Well, sort of.

Rod of Asclepius
(via Wikipedia)

It turns out using the Caduceus, two-winged serpents entwined around a staff, as a symbol for healthcare is a case of historical mistaken identity. The official badge of medicine is the Rod of Asclepius, a single wingless snake coiled around a simple rod. Asclepius, son of Apollo, is the greek god of healing.  The cult of Asclepius– who set up healing temples around Greece– originated the Rod, and it has survived from antiquity. (It is believed that the cult allowed Aesculapian Snakes to slither freely throughout their temples to earn Asclepius’ favor.)

Ok, but why is there a Caduceus at the top of this page and not a Rod of Asclepius? Seems the misunderstanding can be traced back to 1902 when the U.S. Army Medical Corps officially adopted the Caduceus onto their badge. (Legend has it, this is entirely due to the insistence of one, slightly misinformed, officer). The Caduceus has slowly become a fixture of North American iconography ever since.

Hermes holding the Caduceus
(via Wikipedia)

But the plot thickens. The Caduceus stems from the greek messenger god Hermes, who carried it on his journeys. Hermes is the patron god of travelers, poets and merchants. Given the fact that healthcare in America has bloomed into BIG business (“U.S. spending annual on physicians per capita is about five times higher than peer countries“), maybe the Caduceus has  become the more appropriate symbol.  Then again, maybe it is not that simple considering Hermes is also the patron of tricksters and thieves.

What do you think? Should HealthCare Savvy be sporting the Caduceus or the Rod of Asclepius?

I happened to be paying for trash services (one bill) at the same time as hospital medical services (two bills). One medical bill was for the doctor and the other was for the hospital.

A comparable billing arrangement on trash services would have been to receive one bill for trash collector services and another for the cost of the truck used to haul the trash.

The double billing arrangement puts distance between the medical providers and the facilities they use, and likely simplifies life for the providers, but it also separates the providers from knowledge of the true cost for medical care. Double billing also means that patients have more difficulty trying to decipher the billing.

Let’s hope that trash collectors and other service providers do not adopt a similar double billing arrangement.

As a presidential election looms and the American economy struggles to recover, the spiraling costs of healthcare have become a contentious political focal point without an obvious solution. Yet for patients and their caregivers, opportunities to get more bang for our buck present themselves every day. Over the last two years, as part of the Costs of Care Essay Contest, we have collected hundreds of anecdotes from all over the country that are filled with lessons learned.

Some stories describe all too common medical oversights. Renee Lux, a patient from Connecticut wrote to us about an unnecessary CT scan her doctor should have never ordered that labeled her with a preexisting condition and caused her insurance premiums to skyrocket. Other stories describe easily replicated ingenuity. Molly Kantor, a third year medical student, told us how she figured out how to treat her patient’s heart failure on a $100 budget.

Increasingly, these stories and the insights they provide are striking a chord, helping drive an important professional discourse that in recent months has reached the New England Journal of Medicine and even the Institute of Medicine. This effort has been buoyed by the success of the ABIM Foundation’s Choosing Wisely Campaign, and several other notable initiatives aimed at getting caregivers to examine their own role in healthcare spending.

That is why this year we’re running the contest again.

With the help of Jeffrey Drazen (editor-in-chief, New England Journal of Medicine), Donna Shalala (former United States Secretary of Health and Human Services), Zeke Emanuel (ethicist and former White House healthcare advisor) and Pauline Chen (surgeon and New York Times columnist), Costs of Care will be awarding $4000 in prizes to stories that best illustrate the importance of cost-awareness in medicine.

All stories are fair game and everyone is welcome to participate – examples may include a time a patient tried to find out what a test or treatment would cost but was unable to do so, a time that caring for a patient generated an unexpectedly a high medical bill, or a time a patient and care provider figured out a way to save money while still delivering high-value care.

Submissions are due to contest@costsofcare.org no later than November 15, 2012.

 Learn more at www.CostsOfCare.org/Essay

Neel Shah, MD is the Executive Director of Costs of Care and a chief resident in obstetrics and gynecology based at Harvard Medical School.

A colleague at WBUR slammed her right pinky finger in one of our heavy studio doors a few weeks ago. When she got home that night she realized that the gash was deep enough to need stitches. It was after 8 p.m., on a Friday, so her doctor’s office was closed for the weekend. She went to the local ER.

Two-and-a-half hours later, most of which involved waiting, she went home with two stitches. She just got a $1,059 bill from the hospital (The total cost of her visit was $1,134, but the bill was reduced by her $75 ER co-pay).

She was mystified by “how two stitches could possibly cost more than eleven hundred dollars?” She called the hospital and asked for an itemized bill. Here’s what she got:
It’s a little hard to read the scanned copy, but if you look at the second line, that accounts for a $400 charge, you see this explanation: SIMPL REPR SCLP/AX/GEN.

We’ve been trying to guess, in the newsroom, what “simple repr sclp/ax/gen” means? Anyone? Couldn’t the billing staff at least send an explanation with full words?

My friend’s finger healed well.  It should, she says, for $1134.