Online tool that gives consumers average costs for over 70 medical procedures now live

March 02, 2015
Area(s) of Interest: Patient Care Practice Management Public Health 

A new online tool that gives consumers an idea of the cost for several health care procedures went live last week. Launched by the Health Care Cost Institute (HCCI), an independent, non-partisan, non-profit organization, Guroo.com shows average amounts paid for over 70 common care episodes in most states, including much of California.

Using data supplied by Aetna, Assurant Health, Humana and UnitedHealthcare, the website pulls cost information from the medical claims of more than 40 million U.S. residents. According to HCCI, the prices are averages of the total payments to providers (i.e., what the patients pays plus what the health plan pays) on adjudicated claims by geographic area. The information is put in consumer-friendly terms, with all the cost ranges provided for medical care that is “shoppable” – generally meaning it is elective and can be scheduled in advance.

The new website is free and accessible to consumers, regardless of their insurance status or insurance company. The information is presented using care bundles (e.g., knee replacement, hip replacement) and summarizes the steps of care (when appropriate), showing the cost of each step. The tool also provides consumers with questions they can use when talking with their health care providers to better understand their choices and help achieve a quality health outcome.

Although Guroo.com was designed specifically for consumers, HCCI hopes that this website will also be valuable to employers, policymakers and regulators who can now assess prices and compare costs nationally and locally. HCCI said it also aims to help consumers learn more about their health care conditions, including the common progression or likely steps of care, what to expect and how to prepare for their doctor visit.

While the tool does not yet give provider-specific prices, within a year HCCI expects to let members of UnitedHealthcare, Aetna, Assurant and Humana track spending on a companion site and check how switching caregivers could lower their out-of-pocket costs.

Currently, the database populating the website contains approximately 3 billion claim lines and will be adding 214 care bundles in June. HCCI says that before the end of 2015, it hopes to grow the database to contain claims data from over 100 million Americans, with the addition of Medicare claims data, making it the largest public database of its kind. The website will also add a quality of care feature in the future, though HCCI is still in the early stages of planning the quality component.

Under a federal grant, the California Department of Insurance is continuing to pursue the development of a similar database, though on a much smaller scale, called the California Online Medical Price and Quality Transparency (COMPAQT) initiative. The COMPAQT website currently is scheduled to go online this year, providing cost and quality ratings around five health conditions.

Considering the potential for databases such as these to be used by more patients over the next year, physician practices may want to familiarize themselves with the information being provided on websites such as Guroo.com. Because the cost information provided on Guroo.com depends largely on the allowable amounts paid by the aforementioned insurers, it may differ significantly with the billed charges quoted to any particular patient and lead to a desire for more information from the patient on the cost of a service, particularly for those patients who may still be under their deductible.

Contact: Brett Johnson, (800) 786-4262 or bjohnson@cmadocs.org.


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