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Health-care price shopping gets a toehold on the Web

DULUTH -- If health-care reform were a 1,000-piece jigsaw puzzle, one piece could be the now available online directory for pricing of common medical exams at Minnesota hospitals.

The service -- -- has compiled prices paid by insurers for more than 100 procedures at the 120 medical groups that provide the majority of care to state residents.

Gov. Tim Pawlenty touted the Web site about a week ago as the first resource of its kind nationwide to help improve transparency.

"Providing quality and cost information gives consumers a powerful tool for health-care purchasing decisions," Pawlenty said in a prepared statement. "This reform is part of larger effort to make Minnesota's health-care system even more market-driven, patient-centered and quality-focused. By increasing transparency, we hope to hold down costs and improve quality."

The offering from Minnesota Community Measurement, a nonprofit collaborative of different health organizations, allows anyone to search what the average cost is for many visits such as a child delivery, colonoscopy or a routine checkup.

Here are some of the findings at area hospitals:

ª Vaginal child delivery at SMDC Health System in Duluth costs $3,056 compared to $2,585 at St. Luke's hospital. At Grand Itasca Clinic in Grand Rapids it's $2,469 compared to $2,794 at Fairview Mesaba Clinic Hibbing.

• A colonoscopy at SMDC costs $924, $579 at St. Luke's, $484 at Grand Itasca; and $611 at Fairview.

• A checkup for a 40- to 60-year-old adult is $143 at St. Luke's, $145 at SMDC, $148 at Grand Itasca and $164 at Fairview.

Critics of the Web site point out that the site doesn't spell out what the average cost is for patients and that it lacks understandable quality data.

"You are not seeing the total cost to you," said Jennifer Schultz, director of the health-care management program at the University of Minnesota Duluth. "You are seeing what they are paying the provider. A C-section is not $3,500 at SMDC. I know because I just had one. It is much, much higher than that. The cost should include the space at the hospital and everything used for that C-section. So the hospitalization and other things are not included. I don't know what this means because they don't have my insurance information, so what am I responsible for?"

Thomas Patnoe, president and chief medical officer at SMDC, said his organization welcomes the transparency of cost information, but cautioned that the relatively high cost of care at his health system is not the full story and that value received by the patient must be taken into account.

"We welcome it and are encouraging it actually on the national and state level," Patnoe said. "The whole concept for us is that we want to deliver and we think we do a good job of delivering high-value health care close to home. It's important to use the word 'value' as opposed to the word 'cost' because, when you shop for anything, there is more to it than cost. There is the quality of that product. Looking at the cost of it is only part of the overall equation."

For example, if a patient has a complication during their colonoscopy, SMDC can address that immediately, Patnoe said.

"We have a state-of-the-art endoscopy suite as well as all the specialties that back that up," he said. "That adds value to the insurers and that adds value to the patients."

Jim Chase, president of the collaborative, acknowledges the Web site's limitations, but believes it is a good starting point.

"It's a first step to get people information to see that there are differences," he said. "If you are paying a piece of that with your insurance, it matters to look around and see what your opportunities are."

After pointing out the Web site's limitations, Schultz agreed with Chase.

"This is a great place to start," Schultz said. "I don't want to be too critical of it because you have to start somewhere and right now there is hardly any information on price or quality out there at all. I commend them for starting here. As we go here, we are going to get more and more information, better information on price and quality."