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Published: Wednesday, May 21, 2014, 12:01 a.m.

The Everett Clinic revealing charges for some tests

It's a peek behind a curtain of secrecy that obscures what patients end up paying for medical care. The Everett Clinic, with nearly 308,000 patients, is thought to be one of the first major health care organizations in Western Washington to begin revealing some prices.
The clinic has posted on its website the charges for six medical imaging tests, such as MRI scans and X-rays. It's part of a growing movement in Washington and nationally to address the mysteries of medical billing.
The goal is to let consumers know what their out-of-of-pockets costs will be before having what can be expensive tests, procedures and surgeries.
“Health care is so darned expensive,” said Rick Cooper, chief executive of The Everett Clinic. “Patients deserve transparency on what the prices will be.”
The Immediate Clinic, a walk-in medical care provider with offices in Everett, Lynnwood and six other Puget Sound locations, posts online charges for all services. For example, an office visit costs $120 and a measles, mumps and rubella shot is $90.
But bigger institutions, like The Everett Clinic, traditionally have been less forthcoming about prices, which vary depending on a patient's ability to pay and on agreements between medical providers and insurers.
The prices posted on The Everett Clinic's website are what people without health insurance would pay. For example, an MRI brain scan would cost $1,264. There's a 25 percent discount for those who can pay the bill within 30 days.
These nondiscounted costs are the “sticker prices” submitted to insurance plans. Insurance companies typically negotiate discounts.
Contracts between health plans and medical organizations often prohibit disclosure of what the insurance plans pay for health care. So consumers often don't know what their out-of-pocket costs will be until they open a bill.
What insured patients end up paying depends on factors such as deductibles, maximum annual out-of pocket costs and co-pays.
Iwalani Paquette, director of business services for The Everett Clinic, said the decision to post prices was made because patients often ask about the cost.
Price information on other medical services are expected to be added in the fall, Paquette said.
Cooper said the posting of prices for some of its imaging procedures is a first step.
“We're really trying hard to have patients understand what their out-of-pocket costs will be for the services here, particularly when it's the more expensive services that they need,” he said.
Stephanie Marquis, a spokeswoman for the state Insurance Commissioner's office, said that with the new federal law requiring people to have health insurance, consumers are being asked to be savvy shoppers. “But we're not providing them with all the tools necessary to be better shoppers,” she said — namely, prices.
A study published in March by the University of Chicago said that more than 30 states have taken steps to improve price disclosure.
Such steps have reduced the charges for common, uncomplicated elective procedures by about 7 percent, the study says.
“Once you have real competition, you can see prices come down,” said Bob Crittenden, a health policy adviser for Gov. Jay Inslee.
A study by the Washington Health Alliance, a Seattle-based nonprofit, found a 500 percent price difference between the highest and lowest prices for back surgery, he said.
“Every place we've looked has always found big variations in prices,” Crittenden said. “You get that variation when people have a cloak of nondisclosure so they can charge anything they want.” When prices are publicly disclosed, “people change their prices,” he said.
A bill that would have created a database to allow consumers to compare prices was introduced in the Legislature this year. But in the end, the requirement was approved only for state employee health plans and those on Medicaid.
Clay Holtzman, a spokesman for Swedish Health Services, said his organization doesn't post any prices online. Swedish did cut fees for outpatient services for the uninsured by an average of 35 percent Jan. 1, he said. The price for an MRI brain scan went from $6,143 to $1,810.
Preston Simmons, chief executive of Providence Regional Medical Center Everett, said his organization recently cut imaging prices for the uninsured, too. For example, at its outpatient clinic in Monroe, the charge for an MRI brain scan is $860.
In addition, the Washington State Hospital Association has a website where consumers compare charges for common procedures, he said.
Simmons said he liked what The Everett Clinic has done. “I think we'll look at doing something similar,” he said.
Sharon Salyer: 425-339-3486; salyer@heraldnet.com.
Story tags » EverettEverett ClinicHealth organizationsHealth insurance

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