Jeffrey Rice, MD, JD, trained at Duke University as a radiologist, but while still in residency his career took an atypical turn. Rice got involved in the project of linking the Duke University Health System with an insurance company to put together a managed healthcare plan.
That experience caused Rice to become interested ways of helping consumers learn how to talk about the quality of medical care that they received. That led to the development of CareSteps.com, a technology company that was eventually acquired by Healthways, the country’s largest disease management company.
With two successful company launches under his belt, Rice said he realized something about healthcare that had not been clear to him before. He said he began to understand that “when healthcare providers did not complete on price, they also didn’t compete on quality either”.
Rice said that the obvious examples of heath care providers competing on price are those who are generally not compensated through insurance plans such as cosmetic and lasik eye surgeons. Rice said that these two areas of medicine compete on price which also forces them to compete on quality.
So, Rice reasoned, if we can get providers to compete on price, it just might also raise the standard of care. Out of this line of thinking came HealthcareBlueBook.com, a free online guide to fair health care pricing.
Rice said, “If you pay for your own healthcare, have a high deductible or need a service your insurance does not fully cover, we can help. The Blue Book will help you find fair prices for surgery, hospital stays, doctor visits, medical tests and much more.”
The concept is simple, just enter your zip code and the type of physician’s visit or medical procedure that you need and the Blue Book will return the “fair” price for that service in your area.
For example, enter Colonoscopy (no biopsy), and the zip code 66210, and the Blue Book will return the following prices for each of the components of the procedure:
Physician fee: $476
Facility Services: $373
Anesthesia Services: $439
Rice said that the pricing is based on a mid-level price that a typical Preferred Provider Organization (PPO) would pay for the service after taking a discount from billed charges.
“Heath care pricing has a problem,” Rice noted. “Providers give their best prices to their worst customers. The lowest discounts are given to health plans that require the provider to do a large amount of paper work and then wait for reimbursement. The Healthcare Bluebook is a way for consumers and providers to quickly determine what a fair cash price would be for any particular service.”
Rice said that since the Healthcare Blue Book was released in early January, he has received very positive feedback from consumers and providers alike. “We know that people are using the site both before and after obtaining medical services.”
Rice said that he has also received interest from large employers who have embedded the Healthcare Blue Book into the benefits portals that their employees access for healthcare information.
Another group showing interest in the website are physicians who view the site as a potential source of new patients who are willing to pay cash for services if they are able easily negotiate a discount from full billed charges. The Healthcare Blue Book provides an easy an independent way for both the provider and the patient to determine a fair price.
Rice said he is already working on new ways to use the data and to create tools that will push this information to consumers at the time they need the information most. In the meantime, Rice still hasn’t gotten around to starting that medical practice.