Healthcare Blue Book
Encyclopedia
The Healthcare Blue Book, owned by privately held CareOperative LLC, provides free online tools designed to enable consumers to understand how much they should pay for healthcare services.
The company website allows consumers to look up the fair market cash price for thousands of medical procedures, diagnostic tests, medications and other services. The company’s fair price is the amount a cash paying patient should pay for a service. Specific price data are available by US zip codes, allowing users to customize the results to their local area.
The fair price represents the amount that many providers accept from insurance companies as payment in full for a service. This amount is typically lower than a provider’s “list price”.
The fair price is calculated from industry data on numerous providers, payors and employers across the United States.
, United States
. The Healthcare Blue Book is owned by CareOperative LLC. CareOperative LLC provides information, tools and processes that enable fair, upfront pricing for healthcare services and products.
(CDHP), High Deductible Health Plan
s and other consumer oriented benefit designs.
outlined a case for improved healthcare quality and lower cost resulting from increased patient consumerism. The study found that the keys to realizing the value of consumerism are two-fold. First, patients need to act as consumers since they are paying a larger out-of-pocket proportion of their healthcare. Second, consumers must have access to pricing information from providers before the service is rendered.
Americans are paying more out of pocket for their healthcare services. According to the US Census Bureau, in 2007 there were 45.7 million uninsured Americans. Out of pocket costs for the 177 million Americans with employer sponsored insurance have also increased. A 2008 Mercer
study reports that median healthcare deductibles for the working insured have increased from $500 to $1,000 between 2007 and 2008. A similar Hewitt Associates
analysis also reports overall out of pocket healthcare expenses have risen from $1,576 to $1,707 over the same period.
Despite the fact that out of pocket costs are rising, the promise of true consumerism has been stymied by the lack of free, accurate and easily accessible tools that enable patients to effectively shop for the best provider price. The lack of price information is highlighted by the NCPA study:
The company’s core services seek to address the key deficiencies in healthcare price transparency by providing tools that address the healthcare price knowledge gap.
The company website allows consumers to look up the fair market cash price for thousands of medical procedures, diagnostic tests, medications and other services. The company’s fair price is the amount a cash paying patient should pay for a service. Specific price data are available by US zip codes, allowing users to customize the results to their local area.
The fair price represents the amount that many providers accept from insurance companies as payment in full for a service. This amount is typically lower than a provider’s “list price”.
The fair price is calculated from industry data on numerous providers, payors and employers across the United States.
History
The Healthcare Blue Book was founded in 2008 and is headquartered in Brentwood, TennesseeBrentwood, Tennessee
-Demographics:As of the census of 2000, there were 23,445 people, 7,693 households, and 6,808 families residing in the city. The population density was . There were 7,889 housing units at an average density of . The racial makeup of the city was 94.63% European American, 1.89% African American,...
, United States
United States
The United States of America is a federal constitutional republic comprising fifty states and a federal district...
. The Healthcare Blue Book is owned by CareOperative LLC. CareOperative LLC provides information, tools and processes that enable fair, upfront pricing for healthcare services and products.
Services
The company works with consumers, employers and providers of health care services to develop tools that advance their mission of fair, upfront pricing in healthcare.Healthcare Consumers
Consumers may access all of the company’s services for free. The pricing tool allows consumers to look up the fair cash price for thousands of services including in-patient surgery, outpatient surgery, physician visits, diagnostic and laboratory tests, prescription medications, cosmetic surgery and dentistry. The website also provides a practical guide to healthcare consumerism and tools for negotiating and documenting provider fees.Employers
The company provides a customized version of their website for employers. The employer service supports implementation and management of Consumer Directed Health PlansConsumer driven health care
Defined narrowly, consumer-driven health care refers to third tier health insurance plans that allow members to use personal health savings accounts , Health Reimbursement Accounts , or similar medical payment products to pay routine health care expenses directly, while a high-deductible health...
(CDHP), High Deductible Health Plan
High Deductible Health Plan
A high-deductible health plan is a health insurance plan with lower premiums and higher deductibles than a traditional health plan. Being covered by an HDHP is also a requirement for having a health savings account. Some HDHP plans also offer additional "wellness" benefits, provided before a...
s and other consumer oriented benefit designs.
Healthcare Providers
The company invites healthcare providers to participate in their service by providing cash prices for healthcare services that can be used by consumers.The Need for Healthcare Price Transparency
A 2007 study by National Center for Policy AnalysisNational Center for Policy Analysis
The National Center for Policy Analysis is a non-profit American conservative think tank whose goals are to develop and promote private alternatives to government regulation and control...
outlined a case for improved healthcare quality and lower cost resulting from increased patient consumerism. The study found that the keys to realizing the value of consumerism are two-fold. First, patients need to act as consumers since they are paying a larger out-of-pocket proportion of their healthcare. Second, consumers must have access to pricing information from providers before the service is rendered.
Americans are paying more out of pocket for their healthcare services. According to the US Census Bureau, in 2007 there were 45.7 million uninsured Americans. Out of pocket costs for the 177 million Americans with employer sponsored insurance have also increased. A 2008 Mercer
Mercer (consulting firm)
Mercer is a human resource and related financial services consulting firm, headquartered in New York City. The firm operates internationally in more than 40 countries, with more than 19,000 employees, and is the world's largest human resource consulting firm....
study reports that median healthcare deductibles for the working insured have increased from $500 to $1,000 between 2007 and 2008. A similar Hewitt Associates
Hewitt Associates
Hewitt Associates , based in Lincolnshire, Illinois, United States was a global human resources outsourcing and consulting firm delivering a complete range of integrated services to help companies manage their total HR and employee costs, enhance HR services, and improve their workforces.Hewitt...
analysis also reports overall out of pocket healthcare expenses have risen from $1,576 to $1,707 over the same period.
Despite the fact that out of pocket costs are rising, the promise of true consumerism has been stymied by the lack of free, accurate and easily accessible tools that enable patients to effectively shop for the best provider price. The lack of price information is highlighted by the NCPA study:
In most markets, prices and quality indicators are transparent - clear and readily available to consumers. Health care is different: Prices are difficult to obtain and often meaningless when they are disclosed. Patients who ask for price information are likely to be disappointed. Typically, neither the hospital nor the doctor will know the cost until the procedure is completed.
The company’s core services seek to address the key deficiencies in healthcare price transparency by providing tools that address the healthcare price knowledge gap.