Thursday, March 31, 2011

Q: Where do you get the best price for an MRI?


 How can you find the best price for an MRI (and why would you care)? I should have gone to Medibid.com, but didn’t. “My bad,” as the kids say.

My wife tore her meniscus during 2009. By the spring of 2010, the pain had finally became too great. We though she needed surgery. Since we have a Health Savings Account (HSA), though, we wanted to make sure an expensive surgery made sense.

We headed to Summit Orthopedics to see Dr. Jack Drogt.

Drogt suggested first to treat her with a cortisone shot, rather than recommending an MRI and surgery. That made sense. The shot, at $180, could knock the pain down and surgery – at thousands of dollars – could be unnecessary. (He never said it, but I suspect this is a practice guideline for all but the most obvious surgical situations.)

Weeks later we returned with the sorry report: The knee hurt, and perhaps even more. Drogt prescribed an MRI with a consultation thereafter.

Can you tell me the price of an MRI (no fair looking at an Explanation of Benefits – once you have that, it’s too late to worry about price)? Have you ever asked? If you did, would anyone tell you? Do you care about the price? You do if you have an HSA and want to hang onto your money.

In Minnesota, the law requires doctors, hospitals, and insurance companies to tell you ahead of time the price of a medical service, product, procedure, medicine, and so forth. The law (Sec. 62J.81) calls this price quote a “good faith estimate;” like going to the auto repair shop to get new brakes. Auto mechanics are used to giving you an estimate – doctors not so much, but this transparency idea is a new thing.

I called three MRI service providers. One quoted $1,050. A second, $980. These two clinics were free-standing, non-hospital based. I knew better than to call the hospital for a quote, because I had made that mistake in 2008. The third option, an MRI machine dragged around in a 40’ trailer, gave an $750 estimate, but I felt wary of their service.

I also knew about Smart Choice, an MRI clinic in Milwaukee. Smart Choice promises a $600 price for all MRIs, regardless of what kind of scan the doctor prescribe. I had to decide whether it was worth it for me to drive five hours to save the money, and therefore, chose not to do so.

We chose the $980 option – and wasted $600. I could have checked Medibid.com, and received the MRI for less than $400 at a clinic just a few miles away.

Medibid.com, founded by my good friend and Canadian expatriate Ralph Weber, allows a person to input a request for bid for a variety of medical procedures, including MRIs. You should check out Medibid.com right now (no, this is not a commercial and I do not get paid for it – I just believe in what they are doing).

Dr. Drogt performed the surgery, and my wife received therapy at his clinic. We spent several thousand dollars, but her knee seems “fixed.”

Drogt is a first-class orthopedic surgeon, but guess what? If I would have gone to Medibid.com, I could probably have found an equally first-class surgeon in a nearby community to do the surgery and saved hundreds or thousands of dollars. (Now I remember!)

I tell you about Medibid.com because it is an example of how the marketplace can answer the health care pricing problem. It is not “the” answer, it is “an” answer.

What we must guard against is a government bent on destroying the Medibid.com types of  innovation or the two people working day and night in a garage somewhere to create the next miracle medical device.

What I fear, and fear is the right word, is an Independent Payment Advisory Board deciding that even though Medibid.com is a fabulous idea, it does not fit their payment model and therefore, must be shut down. Or, it must be shut down because Ralph Weber is an outspoken critic of government-run health care.

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