How To Prevent Medical Bill 'Sticker Shock'

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Medical bills are the leading cause of personal bankruptcy in America, despite the fact that more people have health insurance and expanded coverage under Obamacare. "Sticker shock" after receiving a medical bill is becoming a rite of passage for Americans. That's what happened to Carey Goldberg, co-host of WBUR's CommonHealth blog. She wrote about this in her recent post "Medical Bills That Make You Say WHAT?!"


Carey Goldberg, co-host of WBUR's CommonHealth blog. She tweets at @commonhealth.

Dr. Neel Shah, founder and executive director of Costs of Care, and a member of the Harvard Medical Faculty Physicians practice at Beth Israel Deaconess Medical Center. He tweets at @neel_shah.

How To Prevent "Sticker Shock"

Carey Goldberg: "You need to talk to your doctor. You need to basically say to your doctor, and not be embarrassed to say, if we're going to cross the line from preventive to potentially billable, I want you to give me a heads up so I can make a decision about whether I want to go there."

Neel Shah: "It's not uncommon for people to have $5,000 deductibles. It's fairly common. One of the takeaways is that, even for routine care, you can blow through that deductible. I'm an obstetrician and I see people for relatively routine services — a couple pre-natal visits and a couple ultrasounds and you've gotten up to that deductible. One emergency room visit, and you've gotten up to a couple thousand dollar deductible."

NS: "A lot of health plans have cost estimator tools. Beth Israel Deaconess is rolling out a price estimator tool as part of this new legislation in Massachusetts, as a way of responding to it. There are a lot of private companies that are trying to create a Yelp for health care."

NS "There are companies out there. In fact, Castlight Health is one of these companies that just had an IPO to become a Yelp for health care. Raised something like $200 million in venture capital to do this. And the way they work is by taking the benefits statements from large employers and reinterpreting them for patients in a way that's more understandable. And they see a business case that's literally that big to do this in order to avoid the kinds of failures or problems that Carey has illustrated, or at least we've seen in the comment thread."

NS: "So, understand your benefits, take the opportunity to ask, and then take advantage of the growing number of tools that are out there. In fact, if you were to Google the price of a common test or treatment in 2014 you're likely to get a sort of blue book value estimate. In fact, there's even a website called Healthcare Bluebook. Whereas a couple years ago, none of that existed."

NS: "This is becoming a cottage industry. So that's one big resource, another resource is the Choosing Wisely campaign, and this is a partnership between medical professional societies and folks like the consumer union and the AARP to create lists of the top five tests in every sort of domain that doctors and patients should question. And Consumer Reports is actually creating lists of not only the tests but how to talk to your doc about them."


CommonHealth: Lesson Of The $446 Ear Rinse: Medical Bills That Make You Say ‘What?!’

  • "My health bills for preventive care had all seemed reasonable until now — or at least, they were bountifully paid by insurance. Mammograms, children’s check-ups, all were fully covered. But I’d shifted recently to an insurance plan with a $500 personal deductible, and I’d made a naive mistake: When my doctor kindly offered to clean my waxy ears during my annual check-up last April, I said, 'Okay…'"

CommonHealth: 5 Measures To Compare Childbirth At Mass. Hospitals

  • "Childbirth is one of the most important medical events of our lives, if not the most important. We want to make sure our moms and babies get the best possible care. But we often choose that care based solely on reputation or word of mouth."

This segment aired on March 17, 2014.


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