NH Health Cost Transparency: Ultrasound heart examination

cardiac ultrasound, NH 2014 HMO, elective, Hospital setting
cardiac ultrasound, NH 2014 HMO, elective, Hospital setting

We recently wrote about the top 20 services for females between the ages of 40-50, Females, 40-50.

Today we look at a common service for men between 40-50: an ultrasound examination of the heart.  For those males who experienced an out-of-pocket cost for this service in 2014 the average expense was over $826.  We decided to look at only those claims associated with an out-of-pocket expense because presumably it would tend to capture consumers with high deductible plans.  There are hundreds of cases where no out-of-pocket was incurred because of the plan design, but for those the topic of health cost transparency is less meaningful.

In this post we look at the top 5 hospitals performing this procedure in the state in 2014 for HMO plans.  We captured services codes as “elective” as well as those performed in a hospital setting.  Using some powerful data visualization software from R (ggplot2 package), we were able to really let the story tell itself.  Listed are five hospitals – the top five in terms of count, or number of times this was performed in 2014.  The chart setting is “violin” while also inserting a box plot inside the violin that allows us to see the median cash cost to consumers as well as the interquartile range (IQR) of cash prices.  The IQR captures the middle 50% of claims for each hospital.  The violin chart shows density of claim counts at the corresponding cash price levels – the more claims the wider the chart.

What can we make of the hourglass shapes for the hospitals in general?  It is highly likely the result of two dominating health insurance companies accounting for the majority of services.  If there were three horizontal bulges (cue Michael Scott please), it would imply that 3 insurers in the state are reimbursing for the same procedure.  The public data file does not disclose insurance plan pricing so the consumer still needs to pick up the phone to verify relative pricing hunches.

For those looking to potentially save cash, the major “wow” moment comes by comparing the median paid at Exeter Hospital vs. Wentworth-Douglass Hospital.  The average cash cost difference was around $1,000.  This is a prime example of where taking a proactive approach to consumer engagement in managing healthcare budgets can mean serious savings.  If a consumer on average saves $1,000 annually in a health savings account (HSA) for 20 years and invests the savings at an annual return of 6%, the future value would be over $36,700 (an assumption).   It could probably cover your annual dental expenses in retirement.  In fact, assuming $3,000 per year in dental expenses, if the assets continue their 6% annual return, that $36,700 could last a consumer 21 years, or through 85 years of age.  At that point there will probably be 3-D printing machines pumping out dentures, so you’d be good to go.

While we may sound like a broken record, our site should be used by consumers with high deductible plans looking to use a health savings account as a retirement income savings vehicle.  We would submit that while we are not the “sexiest startup” in New England, we certainly add value for the savvy and discerning consumer in NH looking to take ownership of their future retirement income picture.

Consumers can register to access our NH health cost tool at HealthyHive New Hampshire.

Please reach out with comments or questions on other services.  And please also inform others looking for a valuable health cost transparency resource.




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