Web sites help patients compare costs of care

Leslie Ramirez, MD, an internist from Chicago, sees patients every day who don't have insurance and can't afford the treatments or tests she recommends. But when she heard about one particular patient, a woman in her early 60s who couldn't afford her annual mammogram, Dr. Ramirez realized she needed to do something.

"That patient was my mother," said Dr. Ramirez, who decided to launch Leslie's List, a Web site where patients can compare costs for tests and procedures and find clinics that offer free or discounted care (link).

While several insurers have created Web sites for members to compare prices, other independent operations, such as Leslie's List, also have launched over the past few years.

Another site, OutOfPocket.com, allows anyone to enter price information for health care services they have received. Healthcare BlueBook, another independent site, collects cost data from various health care facilities, payers and employers.

Leslie's List, which launched in February, had more than 14,000 visitors in its first month, Dr. Ramirez said.

William A. McDade, MD, PhD, president of the Chicago Medical Society, said he worried a system like this could lead to antitrust troubles if clinics consult the list to set their own prices.

But antitrust expert Arthur N. Lerner, partner at the Washington, D.C., offices of the law firm Crowell & Moring, disagrees. "Antitrust laws normally operate under the assumption that informed sellers and buyers, or in the case of health care, that informed health care facilities and informed patients, make the market work better."

Lerner said the pricing sites, even those run by physicians, are no different from travel sites where airlines and hotel chains post prices.

But Dr. McDade said he also questions price accuracy. Prices quoted by hospitals might not be the whole package, he said.

Leslie's List has a disclaimer stating that the listed prices may not be complete, accurate or updated. Dr. Ramirez also says that many of the prices do account for any additional fees and the site will break those fees down, detailing who is paid what amount.