Find the Best Value for an MRI

Several years ago I decided to switch to a high-deductible health insurance plan (HDHP) for myself and my family. I pay 100 percent of my own health insurance premiums and one of the factors that influenced my decision to switch was how expensive my insurance premiums were getting even though I basically made no insurance claims over the past five years, other than annual check-ups. After my accountant suggested I look into high-deductible plans, I calculated that I could save $7,000 in premiums every year and use my HSA to help pay for my medical expenses. With my HDHP I have become a cost-conscious consumer of health care services, and I shop around for the best value, just like I would shop around for a car or electronics. The only problem is there are no Consumer Reports for health care where I can easily find the best value for health care services. I have no meaningful tools to help me make informed choices about where to find the best value for routine health care services like MRIs, X-rays, vaccinations, mammograms, and office visits. How do I avoid the overpriced providers with poor performance ratings? Now that I pay out of pocket for these services (up to $5000), how do I shop for value? How do I find out what other patients think of a physician that is listed in my plan’s network?

I was a competitive runner for more than twenty-five years, and recently I started to experience a severe pain in my knee that just would not go away. No matter how much ice, rest, and physical therapy—the pain was persistent. So I finally made an appointment to see a sports doctor. After the doctor spent ten minutes with me, he suggested I have an MRI on my knee—which is a very expensive test for someone that has to pay for the entire bill out of pocket. I mentioned to the doctor that I had a high-deductible insurance plan and he gave me several diagnostic facilities to contact. Being the savvy consumer that I am, I called every single facility. In fact, I even called my health plan provider. I called diagnostic facilities in and near my neighborhood. I learned that an MRI is an expensive test that can cost anywhere from $500–$2,500, depending on where I decide to go for the test. And to make matters worse, not a single provider, or insurance carrier could tell me what my out of pocket cost would be for an MRI with my health current insurance plan. I learned that my health insurance plan negotiated discounts with providers. Some discounts were more substantial than others and this could make a big difference in MY PRICE. Every health care provider and health insurance representative I talked to would not share price information with me. This rude awakening was the beginning of a journey for me. I realized first hand that consumers need easy access to meaningful tools to help them make informed decisions about where to find the best value. To be honest, I was not shopping for a complicated surgical procedure; I was just looking to find the best price and quality for an MRI so I could find out why I am in so much pain when I run. I did not want to be overcharged—I just wanted to pay a fair price. Is that asking too much?