Health Insurance

Out-of-pocket health costs rise, but prices often hidden

You're personally paying more for health services. But good luck trying to shop around for a better deal.

A new analysis finds that Americans with health insurance through their employers paid almost 7 percent more for out-of-pocket medical costs in 2013 compared to 2012—rising from an average of $662 per person annually to $707.

The increase comes as more people are enrolled in so-called high-deductible health plans, which require them to directly bear a larger share of health costs.

The same study by the Health Care Cost Institute also looked at what people paid out-of-pocket for services in nine states, and found a wide range of costs.

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Some people paid less out-of-pocket for certain services, while others getting the same services in the same state paid significantly more, according to the institute. The study examined variations in costs of five services: new doctor visits, cataract removal, colonoscopies, lower leg MRIs and pregnancy ultrasounds.

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"Some may interpret the out-of-pocket variations as discouraging, but the results demonstrate that there are real opportunities for consumers to save on health-care spending," said the report entitled "Shopping for Health Care Makes 'Cents' for Consumers."

Those opportunities come from discretionary medical services that can be scheduled by patients, who can theoretically shop for the best price.

Institute Executive Director David Newman said, "I'm not going to be shopping for the ambulance and the hospital during my heart attack."

Nationally, on average, the prices people directly paid for a new doctor's visit varied by $19, according the report.

But within that average was a wide range. In Arizona, the study found, there was an average of $10 difference in what people actually paid for their share of a new doctor's visit, while in Wisconsin the average variation was $35.

For surgical procedures, the range is even more dramatic.

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For cataract removal, the national average variation was $444 in out-of-pocket costs.In Wisconsin, they varied by $989. In Georgia, the variation was $490.

"The variation in consumer out-of-pocket payments for a lower leg [MRI] was $342 nationally," the institute said. "In several states, including Ohio, Texas, and Wisconsin, payments varied by more than $410."

Eric Barrette, author of the report, said, "If people spend a little time, and it's worth it to spend the time. ... they can save $10, $15, $20 for a new doctor's visit."

"On the other hand, they can save $200, $300, or $400 on cataract removal," Barrette said.

While the obvious strategy for people who want to limit their out-of-pocket medical costs is to shop around for the best price, that's often easier said than done.

"Today, consumers are flying blind when it comes to health-care prices. They don't know what they are buying or how much it will cost," said Newman. "The lack of transparency of medical prices is a growing problem since consumers are financing a larger and large proportion of their care."

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Newman said people's reluctance to ask providers about prices, providers' lack of knowledge about what share of the cost that patients will pay and variation in insurance plan designs all conspire to thwart efforts to effectively shop for medical services based on price. Health providers charge different insurers different rates for the same services.

"It's difficult," Newman said, adding that the institute plans to launch two price transparency tools this year, the first within a few weeks. "We're trying to make it a little easier."

Newman said he thinks consumer demand for transparency will increase as more people enroll in high-deductible health plans, particularly customers of government-run Obamacare exchanges. Individual health plans sold on those marketplaces often have higher deductibles than people covered by job-based plans.

"These folks are looking for price information," Newman said. "We need to provide the information."