BUSINESS

Massachusetts health plans post prices on the Web

Physician fees are incorporated into listings that are intended to make patients cost-conscious.

By Robert Kazel, AMNews staff. July 12, 2004.

Harvard Pilgrim Health Plan has joined two other insurers in Massachusetts that are using Internet Web sites to tell patients how much their treatment costs -- information that incorporates physician and hospital fees and expenses relating to lab tests and diagnostic procedures.

The sites are aimed in particular at those enrolled in high-deductible, consumer-directed group plans who might be motivated to keep out-of-pocket costs as low as possible.

On Wellesley, Mass.-based Harvard Pilgrim's site, items range from urinalyses ($3 to $5), liver-function panel blood tests ($11 to $17), and allergy shots ($20 to $24), to myocardial perfusion scans ($589 to $1,009), brain MRIs ($717 to $1,240) and arthroscopies ($2,141 to $3,180).

The costs listed take into account all care associated with a given medical service, including the discounted fee paid to the physician. A serum cholesterol test, for instance, would include the cost of drawing blood, the price of the lab work and the physician payment. The range of prices represent a spectrum of costs that varies because doctors' and hospitals' contracts have different fee schedules.

Although doctors sometimes have been able to get pricing information from payers, allowing patients themselves easy access to the cost of care is a new development with the introduction of consumer-directed plans. These plans offer relatively low health premiums, but deductibles typically are $1,000 or more for individuals or $2,000 for families.

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