Orbitz for Docs? Not Yet.
In a few weeks, employees at The Washington Post Co. get to sign up for health care for the following year. And like a lot of companies and the federal government, The Post has embraced "consumer-driven" health care to help keep health care costs down.
Consumer-driven health care generally involves tax-sheltered accounts that consumers draw upon to pay for certain medical expenses. In some cases, consumers put money into the accounts. In other cases, employers kick in money as well. The idea is if consumers have to decide how to spend their health care dollars, they will spend more wisely.
Until recently, consumers haven't had much to base their choices on because they didn't know how much anything cost until they received their Explanation of Benefits. The latest wrinkle in consumer-driven health care is giving consumers access to pricing and quality of care information to let them shop for doctors, hospitals and procedures much the way they would surf the Web for a digital camera or a vacation package.
Since late August, Aetna members in the Washington area have been able to compare rates and quality of care ratings for doctors at its Web site.
As an Aetna member staring down the possibility of being forced to trade my cushy PPO plan for an HMO or a health savings account just as I'm about to have a kid, I figured I'd give it a whirl.
Under The Post's new plan, the company will put $1,000 in our health savings accounts each year. We don't pay a cent--no deductible or co-pay--for medical or prescription drug costs until we run through the $1,000. Preventive treatments and visits are covered by the plan and don't come out of the $1,000. Once I spend $1,000, I pay 100 percent of my medical and drug costs until I hit an additional $1000, after which I pay 10 percent of my costs if I go in-network and 30 percent if I go out of network.
I decided to search the Aetna site for an obstetrician. I go to a large OB-GYN practice in town, but I'm not 100 percent happy with it. During my last visit, face time with a doctor and having my blood drawn took no more than 10 minutes. But because I had to wait so long at each step of the way, I didn't get back to work for an hour and a half. And it's a five-minute walk from my office.
Here I discovered the down side of Aetna's site--and many similar sites at this point. Useful data on health care quality is pretty much a patchwork, with more complete stats for hospitals than individual doctors, and for common procedures such as heart surgery than for less common ones such as acupuncture. That's partly because not every specialty has standards and not every doctor or hospital has agreed to such scrutiny.
As January W. Payne reported in The Post in August, Aetna has data for 12 specialties, such as cardiology, neurology and plastic surgery, though it allows you to search for practitioners outside those areas. Also, only some doctors, identified with a blue star, have agreed to take part in Aetna's quality rating system.
I compared my current practice to an OB a friend had recommended and got some useful info, just not a lot of it. Both practices met the threshold for three major criteria: volume, clinical quality and efficiency. Volume means the doctor saw at least 20 Aetna members over the past two years. Quality is based on criteria such as whether patients had been readmitted to the hospital within 30 days for the same problem. Efficiency is based on how much the doctor spent to treat a particular condition compared with his or her peers.
Both my current practice and the one I was considering had a check mark in a box next to each category, which means they meet basic competency standards. Good to know. As for the bedside manner-type concerns I had, the site allows you to review survey results for doctors, which could tell me whether they had racked up any complaints. But there were no survey results for either.
The up side for the future is the availability of health care quality information is likely to get better with time. It's still the early days for Aetna's site, which is currently available in only a few select markets nationwide, Aetna spokesman Walt Cherniak said. And an objective approach is more useful for consumers than Best Doctor's lists that are usually based on more subjective measures.
Have you had better luck shopping around for health care? Have you ever had to do it during a serious health emergency?
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