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Re: [projectvrm] I'd like a VRM-style MRI please


Chronological Thread 
  • From: Doc Searls < >
  • To: Amy Gleason < >
  • Cc: =Drummond Reed < >, Johannes Ernst < >, Adrian Gropper < >, ProjectVRM list < >
  • Subject: Re: [projectvrm] I'd like a VRM-style MRI please
  • Date: Mon, 20 Apr 2015 07:39:06 -0400
Agree. 

Johannes, can you please blog this? Thanks!

Doc

On Apr 20, 2015, at 12:07 AM, Amy Gleason < " class=""> > wrote:

Sorry you are having back pain. The two sites that I know that are somewhat trying to solve your problem are 

http://clearhealthcosts.com and https://pokitdok.com/marketplace. Both of these are trying to help find the best price for different medical tests or visits. 

Agree it is totally insane. I would advise you to keep very detailed notes yourself about your pain, what makes it better and worse, what you take for it, visits and tests you have, and questions for the doctor so that you can have a plan for the visit. It is amazing how much of a difference all of that can make! 

Amy

On Sun, Apr 19, 2015 at 11:43 PM, =Drummond Reed < " target="_blank" class=""> > wrote:
Fabulous storyline, Johannes. Congrats (and now I just hope you get over it quickly—back pain is the worst).

On Sat, Apr 18, 2015 at 2:26 PM, Johannes Ernst < " target="_blank" class=""> > wrote:
80% is the number.

Original quote: $1608.

Drove 6 miles, got MRI at: $326.68, for a savings, of, drum roll, 80%.

Low-cost provider started exactly on time. I was back out of the office 48min later, CD with images in hand which I could view on my Mac as soon as I got home.

Now — what kind of industry is this where:

1) a standardized service, in the same area, using the same labor pool, with the same kind of equipment, paying the same rent, can be routinely priced by one provider at 5 times the price of another provider, and they get away with it!

2) a major market participant with a big financial incentive — my insurance company — fails to assist me in finding the low-cost provider, instead of beating me over the head if I decided not to go with them.

and while we are at 3) takes 20% of GDP, while nobody ever quotes prices up-front unless you specifically ask, and price comparison is virtually unheard of.

<end rant>

Cheers,



Johannes.



Also make sure that whatever data the MRI produces can be read by your doctor’s computer, and/or by whatever pathologist (or radiologist, or whatever) he or she will use to make a diagnosis. 

I’ll spare you my tale of woe on that one.

Doc


I haven't used it yet, and I'm not sure if their coverage reaches to medical operations, but worth taking a look at these guys. 


On Wed, Apr 15, 2015 at 5:05 PM, Johannes Ernst < " target="_blank" class=""> > wrote:
The doctor was assuming I’d go to their MRI department. Which I assumed, too, except when I saw that the bill was going to be $1608 dollars. (Of course I had to ask, it’s not like a restaurant, or a store, or pretty much anywhere else where they tell you what the dish is going to cost before you eat it)

Calling around, I found an independent company who offers the same for $600, or, a savings of over ONE THOUSAND DOLLARS.

There’s some money to be made here in nothing else than facilitating arbitrage.




The main challenge for VRM in U.S. health care is that it’s a B2B insurance business more than a B2C care business. Within the B2B context there tend to be relationships between doctors or medical centers and MRI providers. Which leads me to question why your doctor didn’t suggest or require a particular MRI provider. That seems odd. 

FWIW, Yelp rates MRI providers. Here’ a search for San Francisco: <http://www.yelp.co.uk/search?find_desc=mri&find_loc=San+Francisco%2C+CA>

Doc
 

Adrian, for curiosity: what was the difficulty? (This may shed some light on VRM difficulties in general)



Hi Johannes,

This was the business I was in for some 15 years, 3 companies, two of them I founded. One made money, the other failed. It's a long story and complicated. Short version: "I'm sorry".

Adrian

On Tuesday, April 14, 2015, Johannes Ernst < " target="_blank" class=""> > wrote:
Something is wrong with a disk in my spine. So the doctor prescribes an MRI. (Coincidentally the reason why I didn’t show up for IIW/VRM day last week; I was too busy finding ways not to sit, stand or lie down).

MRIs are expensive, but, a commodity. There must be more than a dozen providers in my area that can do this particular MRI:

* I don’t know who they are.
* I don’t know who has a deal with my insurance company.
* I don’t know what their prices are.
* I don’t know how complicated it is to get scheduled
* I don’t know how complicated it is to get their images into the hand of my provider. Some might require sneaker networks, others might have actual networking etc.
* I really don’t want to have to prove to them that my doctor ordered the MRI, not me.

I called my insurance company whose most helpful (not!) help was to tell me that I could find the in the yellow pages, call them all, one by one, to find out.

What I’d like instead is an RFP. From my blog. Offers arriving by e-mail or such.

I’d probably be happily paying $100 to the facilitator of this one-time transaction. I’m sure I could save that by finding a cheaper, more convenient etc. MRI provider.

Please, anybody, set this up? Preferably by next week? ;-)

Cheers,



Johannes.



--
Adrian Gropper MD
Ensure Health Information Privacy. Support Patient Privacy Rights.
http://patientprivacyrights.org/donate-2/ 








--
Matt Hogan
CEO/Co-Founder
DataCoup, Inc.








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