Pricing Healthcare

Pricing Healthcare

Pricing Healthcare

Hello everyone! Welcome back to The Green Swan. Let’s talk today about healthcare and how difficult it is to know you are getting a fair price. I’ve run into this issue every time my wife, son or I have required medical care. I’m sure you have faced similar issues. Especially in today’s world where consumer-directed healthcare plans (i.e. high deductible health insurance) are becoming more and more common, it is important to price shop for the best healthcare options.

Well I have some good news for you! Today I would like to introduce Amino which has recently launched a new service to help you price healthcare. While Amino is not a perfect solution or the end-all-be-all for pricing healthcare, it is a step in the right direction for an industry that has historically been pathetic in terms of price transparency. While Amino is just one of many other public and private companies trying to solve this problem for the healthcare industry, its tools and wide range of details brings the industry the closest it has ever been.

For background, I am introducing you to Amino solely to help you navigate the complex world of pricing healthcare. The services they offer online are free and I have no affiliation to Amino.

Amino

Amino is a “health data company” and has been around since 2013 crunching numbers and data to help provide insightful analysis for the consumer looking to buy healthcare services. Based on the in depth work in its first two years of existence, it launched its first service online in the Fall of 2015. This first service they offered was a quality based metrics on a doctor by doctor basis, helping the consumer/patient find the most suitable physician. In addition to this useful information, in the last month they have begun to show prices by doctor and by insurance plan.Pricing Healthcare

Benefits

  • Amino allows you to search the procedure for pricing based specifically on your geographic location and insurance plan
  • Amino bundles the entire cost of the procedure (e.i. for a pregnancy you may receive multiple bills from the hospital, the doctor, the anesthesiologist, etc.), helping to avoid surprise bills
  • It can highlight regional pricing differences within a city and state
  • Amino’s quality and pricing data covers about 550,000 physicians, 49 procedures, and 129 insurance companies
  • It’s data is based on 188 million individuals’ historical data, hundreds of millions insurance claims totaling $860 billion within the last year

Limitations

There are a few limitations currently, but I believe these are all things they are working to improve going forward.

  • More procedural data is needed, while Amino has hit a lot of the big procedures there is still significant room for growth
  • More quality information would be beneficial. For instance, it may show the rate of replacement surgery for a knee for an orthopedic doctor or rate of c-sections for an OB/GYN which is good info, but more granular and personalized quality info would necessary for a complete decision making process.

Healthcare is daunting. By introducing you to Amino, I hope you benefit by a bit more price transparency. I know it would have helped my family in the few medical issues we have encountered in recent years. And as Amino continues to grow and add more and more detail and services, it should only improve and become more useful.

Pregnancy

Just over two years ago, my wife Lucy and I had our first child. What a magnificent experience, we were both so delighted and our families couldn’t have been happier for us either.

Of course, what we didn’t know was how much this was going to cost us or how much insurance would cover. I had tried calling different hospitals in advance to see how things were priced, but it was shocking how little they knew or were willing to share. I could write a whole post on this alone. And if you’ve been there before, you know what I’m talking about!

Ear Tube Surgery

Unfortunately, the little man suffered through a series of ear infections and we ultimately had to have ear tubes put in for him. This was very tough on both Lucy and I, having to have him put under anesthetics, taking him into a surgery center, putting the little man in gown, the whole nine yards. Fortunately the surgery went very well and it was over quickly.

Prior to the surgery, again I was calling multiple places to find the best and cheapest alternative. Having it completed in a hospital would have been over twice as expensive. Similar to the pregnancy, after the procedure we got multiple bills to pay the operating doctor, anesthesia doctor, the facility fee, and I can’t even remember what else.Pricing Healthcare

Pneumonia

Late in 2015, Lucy contracted pneumonia. No idea how, but she was definitely under the weather for a while. As it was progressing and she was feeling worse, we were driving home from work one day and she was telling me how bad it was. We look back and laugh now, but my response was something to the effect of “yeah, you must have a bad cold, but it’s not like you got pneumonia…”. I was speaking from experience since I had it once as well years ago.

But the next morning it was so bad that she went to the CVS MinuteClinic, and sure enough she was told she likely had pneumonia. Boy did I “eat crow” after that diagnosis. She had to go to a doctor for an x-ray and to get prescriptions, etc. While more of an emergency, it would have still been nice to do a bit of price shopping to find the best venue and doctor (e.g. family practitioner, ER, Urgent Care, etc).

Amino would have likely been helpful in this circumstance. She ended up going to Urgent Care which we think was the best option in terms of getting in right away, cost, etc.

Conclusion

Each of these situations were unique, but all would have benefitted by greater price transparency as well as a simpler and easier to understand healthcare system. For each situation we had to try to determine where to go for the best treatment at the best cost, but it was not easy and it was more or less a crap-shoot.

These situations are normal too, they happen to everyone, there is nothing unique about them, and they all happened in just the last couple years. This is a very routine problem! Amino is here to help and will hopefully continue to get better.

I’m sure you’ve all had similar situations. We are all in this together trying to find the best care for ourselves and our loved ones. If you’d like, please share your experiences with healthcare and the lack of price transparency in the comments below. Could Amino be a useful resource for you? Will you be bookmarking it in your browser?

Thanks for taking a look!

The Green Swan

Work Harder, Work Smarter, Retire Earlier and Find Your Beach

 

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36 Comments on "Pricing Healthcare"

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Jon @ Be Net Worthy
Guest
The lack of pricing transparency in healthcare is truly amazing. Regardless of your feelings about the Affordable Care Act, I think that one benefit is the move to high-deductible plans which puts the onus on the consumer to know how much things cost. Over time, I think the consumer pressure will move the industry towards greater transparency. I also think that companies like Amino offer a fantastic service and I will certainly check them out the next time we need healthcare. Given history, and a full house, it may not be very long! 🙂 Perhaps the healthcare industry will see the innovation flourishing like FinTech has had for the past several years – that would be fantastic! There is another company, and the name is… Read more »
Dividends Down Under
Guest

Amino (acids!) sounds good JW, health insurance is similarly complicated to compare in Australia, luckily there’s a Govt-run website that helps compare, but it isn’t advertised.

It’s sad that we think of health providers (doctors, hospitals etc) of all wanting to do their best and they would all provide value, but sadly that isn’t the case. It’s worth it just as much for research health-related-things as looking for car insurance, a new TV or anything else.

I really like this selfless post JW, nice one.

Tristan

Apathy Ends
Guest

I never know if Going to the doctor (or dentist) is going to be a 20 copayment or a $200 bill in the mail a few weeks later. It. Is incredibly frustrating. I try to look through our insurance coverage but it is confusing and time consuming.

I will bookmark Amino for later, if it has common procedures/treatments I’m sure it will come in handy.

Mr. SSC
Guest
I’ll have to look into Amino, that sounds really helpful! You guys are like our health doppelgangers. 🙂 Last year we had a bout of ear infections with our then 2 yr old, followed by a couple of trips to the specialist for ear tube surgery. Thankfully, when we got there her ears were clear, so we took the “wait for the next one” approach before having surgery and she hasn’t had one since, whew! However, going to the regular dr. every two weeks for almost 3 months, along with meds, and then twice to a specialist blew through our pre-tax health savings by April. We were caught off-guard by the specialists’ bills almost 3 months later because what “should have been covered” when we… Read more »
Physician on FIRE
Guest
I like the concept of what Amino is trying to do. Comparing costs is next to impossible, and most of us physicians are completely disconnected from the billing side of things. There is a huge differences between charges and billing, and payments are negotiated separately with the many different payers. It’s a mess. I plugged in a couple common procedures into Amino, and the site failed miserably to identify who can do them and what it might cost. For total knee replacement, rather than identifying any of the 6 local orthopedic surgeons who do them, I got physician’s assistants from an hour away as matches. I had to go to the 20th result to get one of the local docs. I tried ear tubes, and… Read more »
Hannah Levy
Guest
Hi Physician on FIRE (love the pseudonym!). Hannah from Amino here. Really appreciate all of the thoughtful feedback on our product, and appreciate the time you spent trying out a few different searches. We take data accuracy very seriously, and your specific feedback and first-hand knowledge of your local physicians’ expertise will help us improve the quality and accuracy of our matching algorithm and doctor profiles. I want to make sure I capture all the context of what you’re seeing versus what you were expecting. Would it be possible to share the specific parameters of your search for knee replacement and ear tubes? If you could send the URLs that were generated after you went through the search cards, that’d be super helpful – you… Read more »
Matt @ Optimize Your Life
Guest

This is great! I will definitely put this in my arsenal for future use. It can be so difficult to navigate pricing issues at hospitals.

Your pregnancy situation reminds me of a video that Vox ran where one of their employees called around to try to compare prices for his wife’s upcoming birth. (https://www.youtube.com/watch?v=Tct38KwROdw) Hopefully services like Amino will help lead to a more transparent system.

Hannah Levy
Guest
Hi Matt, thanks for your comment – if you do end up using Amino to find a doctor, would love to hear what you think of the experience. Also, I saw that Vox video when it came out – such a frustrating but not uncommon experience. We’re trying to use our data to help people understand the cost of pregnancy, so keep your eyes peeled for that in the future. In the meantime, we have done a lot of analysis around C-section rates, and have an in-product decision factor related to C-sections (you can see what an individual doctor’s predicted C-section rate is, based on their patient mix). Check it out: https://amino.com/blog/c-section-rates-in-america-state-by-state-analysis-new-c-section-predictor-pregnant-women. Thanks again – if you’d like to share any other feedback please don’t… Read more »
Ray Ray
Guest

Health is expensive business! Companies like Amino help us navigate through the fluff of the industry and explains it is lay-mans terms.
Nice find Mr Swan

FinanciaLibre
Guest

Interesting company – thanks for writing about this.

Pricing health care ex ante is complicated stuff. This Amino thing seems to be a step in the right direction of enhancing transparency a little. But, even with perfect transparency (which is unlikely to ever be achieved in a multi-layered system like health care), actual cost can differ materially from anticipated cost simply because of minor wrinkles experienced in the course of care. Which introduces added complexity in forecasting expenses because of on-duty specialists that may be out-of-network but in the same facility and used by default. Etc., etc.

Amino’s an interesting idea, and I’m glad you covered it – thank you – but the company’s swimming upstream against tough currents in providing even reasonable benchmarks.

Vicki@Make Smarter Decisions
Guest

I have never heard of Amino – but it is really interesting. I totally get what you mean about calling to find out costs of procedures. I did that when I had my hip scoped and it was almost like no one had ever asked those questions before. It was just – oh, you’ll have co-pays and it things aren’t covered fully – you might need to cover something. OK – that’s vague… Heading off to try Amino now.

Hannah Levy
Guest

Hi Vicki! Thanks for your comment. I visited your blog “Make Smarter Decisions” – would you be open to chatting? I’d love to learn more about your audience on the blog and what they’re interested in, and would also like to hear what you think of Amino, too. Let me know – I’m [email protected]. We could set up a call or I could send over more specific questions via email! Thanks, Hannah

Francesca - From Pennies to Pounds
Guest

Sorry to hear that she (and you!) had pneumonia. Not good! I feel so lucky to be in the UK where our healthcare is ‘free’ whenever I see posts from you guys across the pond about healthcare. If I had to worry about that as well it would be so stressful. Good to see that you have some good plans to help you.

Josh @MoneyBuffalo
Guest

Amino sounds like a very interesting service. With all the changes and premium increases here in TN (they just announced another 40% increase starting in October), we went to a self-pay health-share ministry. The responsibility is on us to find the lowest cost provider and sounds like Amino can help!

Hannah Levy
Guest

Hi Josh, Thanks so much for your comment and support. Would love to hear what you think of our service – you can explore cost estimates on http://www.amino.com/cost. If you have any specific feedback, feel free to reach out ([email protected]). Best, Hannah @ Amino

Finance Solver
Guest

Whoa, that’s quite a horror story with the lack of public pricing information. Thank you for sharing Amino, I’ve never heard of them and I think I’m going to keep it in the back of my mind. I just started out being independent last month so I’m having to learn the ropes of everything life alone (in the past, my parents just always knew what was wrong with me) and I understand how important health is. Very informative!

Jen@FrugalSteppingStones
Guest
I’m a Certified Managed Care Nurse and I’ve worked for health plans for 8 years. Even within health plans, making a really well-made search engine that gets a consumer what they exactly need is difficult. I should know, I helped our IT department at work refine ours somewhat, and it still leaves much to be desired. I ran a few searches and, though this gets some information, it isn’t as helpful as it could be. Search 1: I searched for an ultrasound in my local area. It brought up only OB/GYNs. What if I wanted to get a gallbladder ultrasound? If I am a 35 year old female and I put in ultrasound, will I only get a list places for pregnancy ultrasounds? One of… Read more »
Emily @ JohnJaneDoe
Guest

Opaque medical care pricing is probably one of the biggest health care cost drivers. It’s so hard to compare where the best places to get procedures, and price seems to have no relation to quality. I’m glad to see Amino stepping into the information gap.

Doug Arnold
Guest

While I have good coverage on most things with the VA and tri-west. I found emergency room visits are hard to cover. I am glad I found this out on a cheap visit and not some expensive visit.

To me while there has been some good advances in healthcare coverages the government seems to step in create a problem then needs to go back and attempt to fix the problem, which leads to more problems.

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[…] of you may remember a post by the Green Swan on Pricing Health Care that introduced you to Amino. Amino is doing great work and they are growing every day. Here is the […]

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