change:healthcare aims to make medical costs transparent — but falls short in execution

Can social networking help restrain, or even lower, healthcare costs? The Nashville, Tenn., startup change:healthcare is primed to find out.

Healthcare plans are inexorably forcing more cost-sharing on patients — a strategy some call YOYO, for “you’re on your own” — which means that the actual cost of medical care is looming larger for many Americans. Healthcare free-marketers think that’s a good thing, arguing that cost-consciousness will make people better medical consumers and cut down on the overuse of costly services. Their counterparts, meanwhile, worry that fewer people will be able to afford decent care and that individuals motivated to scrimp on medical care will tend to forego preventive check-ups that could catch serious conditions early, thus actually driving up costs over the long run.

Either way, we’re all likely to have to start paying more attention to what our medical care costs, not least because higher deductibles, coinsurance and co-payments are probably going to saddle us with a larger share of the bill. Yet medical pricing is murky to the point of almost complete opacity, since it’s difficult and at times almost impossible to find out what doctors or hospitals actually charge for an appointment or a procedure. Even then, costs can vary widely depending on how old a patient is, where she lives, whether she’s insured or not, and even what hospital or pharmacy she happens to step into.

It’s this informational void that change:healthcare hopes to address with a freshly revamped site that’s just gone live. The new service wraps together the startup’s previous two Health 2.0 services –MedBillManager, a subscription service for helping people manage complex medical bills, and FindYourDoc.com, a physician directory that change:healthcare took down several months back in anticipation of the redesign — and bolsters its social-network aspects, particularly the ability of users to share medical-cost information and rate their doctors or hospitals. The ultimate idea is to build up a database — one supplemented by data from employer healthcare billings, Medicare and other sources — that can help anyone shop around for high quality but inexpensive medical care.

We’ve covered change:healthcare in the past — see here and here, for instance — but I held off reviewing its offerings in light of the pending redesign. That was probably just as well, since FindYourDoc in particular had a slapdash feel to it, thanks to some odd display quirks and some gaps in hospital data that probably weren’t the site’s fault (it relied heavily on Medicare data at the time) but which were disconcerting nonetheless.

More after the jump:
changehealthcare-screenshot-main.gifThe integrated service, which change:healthcare let me view in advance, is certainly intriguing in concept. It offers a directory of doctors and hospitals and separate options to serach and compare medical treatments, insurance and prescription costs. (Click the thumbnail at left for a screenshot.) The original MedBillManager service is also there, although for some reason it’s only available via a link in the site’s banner (under “bill management”) and not as one of the four main options highlighted on the front page, at least in the version I looked at.

changehealthcare-screenshot-doctor.gifUnfortunately, much of the site still didn’t seem ready for prime time at the time I viewed it. I searched on several docs I know, and initially, several didn’t turn up at all. When I was able to find a doctor, the information displayed was distressingly limited (see screenshot at left; I pixellated the doctor’s name because he’s a college friend, not someone chosen at random). Instead of the details I’d expected — address, office hours, and medical-education history — the site throws up an irrelevant graph showing “average cost for top 5 inpatient procedures” that starts with prostate laser surgery and knee replacement — not exactly the kind of procedures you’d expect an ear, nose and throat doctor to be performing.

changehealthcare-screenshot-healthissues.gifThe hospital information is a bit better, as it includes graphs on a given facility’s top five inpatient and outpatient procedures by volume and cost, although it’s still on the bare-bones side. The “insurances” section — I think the site means to use the word “insurers” here — didn’t contain enough data when I checked to form much of an opinion about. The “prescriptions” section was also wonky, as a search for the anti-cholesterol drug Lipitor — possibly the most-prescribed name-brand drug in the world — turned up “insufficient data.” (You actually have to select “Lipitor tablets” and not just “Lipitor” to get to the right page, it turns out.) And I found the “health issues” section is very difficult to wrap my head around, as it’s too limited to really serve as a medical reference and not detailed enough to give me much sense of what the cost-data really shows (see the thumbnail screenshot at left).

changehealthcare-screenshot-mbm.gifFortunately for existing users, MedBillManager appears largely unchanged, hidden away though it might be. The service lets users enter their medical bills and then presents the data in a more straightforward fashion than your typical insurance-company statement (a low bar, to be sure). This not only helps people cut through the morass of insurer bureaucratese so they can track of their actual medical expenses, it coincidentally also feeds data into change:healthcare’s cost database. Users can now try MedBillManager for free, as it allows them to enter up to six bills or statements before it starts hitting them up for a $25 annual fee.

How many of these issues reflect the early days of a nascent social network or the birth pangs of a relaunched site is hard to say at this point. The change:healthcare approach is certainly novel and intriguing, as I’m not aware of any other systematic effort to track medical costs across the spectrum, and with any luck the site will work out its glitches before long. For the moment, however, change:healthcare has a ways to go before it can really begin empowering medical consumers.

The company’s release on its relaunch is here (PDF link).