MONEY Health Care

The Price of Health Care Is Finally Public (in One State)

Massachusetts General Hospital, Boston, Massachusetts
Massachusetts General Hospital in Boston Michael Dwyer—Alamy

This month Massachusetts rolled out total medical price transparency. What can you learn from these new shopping tools?

Without much fanfare, Massachusetts launched a new era of health care shopping last week.

Anyone with private health insurance in the state can now go to his or her health insurer’s website and find the price of everything from an office visit to an MRI to a Cesarean section. For the first time, health care prices are public.

It’s a seismic event. Ten years ago, I filed Freedom of Information Act requests to get cost information in Massachusetts—nothing. Occasionally over the years, I’d receive manila envelopes with no return address, or secure .zip files with pricing spreadsheets from one hospital or another.

Then two years ago, Massachusetts passed a law that pushed health insurers and hospitals to start making this once-vigorously guarded information more public. Now as of Oct. 1, Massachusetts is the first state to require that insurers offer real-time prices by provider in consumer-friendly formats.

“This is a very big deal,” said Undersecretary for Consumer Affairs and Business Regulation Barbara Anthony. “Let the light shine in on health care prices.”

There are caveats.

1. Prices are not standard, they vary from one insurer and provider to the next. I shopped for a bone density test. The low price was $16 at Tufts Health Plan, $87 on the Harvard-Pilgrim Health Care site and $190 at Blue Cross Blue Shield of Massachusetts. Why? Insurers negotiate their own rates with physicians and hospitals, and these vary too. Some of the prices include all charges related to your test, others don’t (see No. 2).

2. Posted prices may or may not include all charges, for example the cost of reading a test or a facility fee. Each insurer is defining “price” as it sees fit. Read the fine print.

3. Prices seem to change frequently. The first time I shopped for a bone density test at Blue Cross, the low price was $120. Five days later it had gone up to $190.

4. There is no standard list of priced tests and procedures. I found the price of an MRI for the upper back through Harvard Pilgrim’s Now iKnow tool. That test is “not found” through the Blue Cross “Find a Doc” tool.

5. Information about the quality of care is weak. Most of what you’ll see are patient satisfaction scores. There is little hard data about where you’ll get better care. This is not necessarily the insurer’s fault, because the data simply doesn’t exist for many tests.

6. There are very few prices for inpatient care, such as a surgery or an illness that would keep you in the hospital overnight. Most of the prices you’ll find are for outpatient care.

These tools are not perfect, but they are unlike anything else in the country. While a few states are moving toward more health care price transparency, none have gone as far as Massachusetts to make the information accessible to consumers. Tufts Health Plan Director of Commercial Product Strategy Athelstan Bellerand said the new tools “are a major step in the right direction.” Bellerand added: “They will help patients become more informed consumers of health care.”

Patients can finally have a sense of how much a test or procedure will cost in advance. They can see that some doctors and hospitals are a lot more expensive than others. For me, a bone density test would cost $190 at Harvard Vanguard and $445 at Brigham and Women’s Hospital.

The most frequent early users of the newly disclosed data are probably providers. Anthony says some of the more expensive physicians and hospitals react with, “I don’t want to be the highest priced provider on your website. I thought I was lower than my competitors.”

Anthony is hoping that will generate more competition and drive down prices.

“I’m just talking about sensible rational pricing, which health prices are anything but,” she added.

Take, for example, the cost of an upper back MRI.

“The range here is $614 to $1,800, so three times,” said Sue Amsel, searching “Now I Know,” the tool she manages at Harvard Pilgrim. “That to me is a very big range.”

In this case, the most expensive MRI is at Boston Children’s Hospital and the lowest cost option is at New England Baptist, with no apparent difference in quality.

“It’s not just for choosing. It’s primarily for getting you the information, about whatever you’re having done, so you can plan for it,” she said.

Most of us don’t have to plan for anything except our co-pay. But about 15% of commercial insurance plans have high deductible plans, in which patients pay the full cost of an office visit or test up to the amount of their deductible, and that number is growing.

“As more and more members are faced with greater and greater cost share, this sort of information is really important,” said Bill Gerlach, director of member decision support at Blue Cross.

To use these tools, you’ll log in on to your insurer’s website. If you have a high deductible, the online calculator shows how much you’ve spent so far this year toward your deductible. If your coverage does not include a deductible, the tool will calculate the balance towards your out-of-pocket maximum.

All these numbers are confusing. Most of us haven’t thought about shopping for health care or paid attention to how much we spend. The state and most of the insurers are rolling out education campaigns to help us wrestle with the previously hidden world of health care prices.

One last tip: Each insurer uses a different title for its calculator. Look for the Blue Cross cost calculator under “Find a Doctor.” It’s not as easy to find as Tufts’ “Empower Me” page or Harvard Pilgrim’s “Now iKnow.”

Both Tufts and Harvard Pilgrim used Castlight Health to build and now run their shopping tools while Blue Cross contracted with Vitals.

Aetna was the first insurer in Massachusetts to offer cost and quality comparisons through its Member Payment Estimator. It’s not clear if all insurers doing business in the Bay State met the Oct. 1 deadline, but all of the major players did. There is no penalty for those who failed to do so.

Kaiser Health News is an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health policy research and communication organization not affiliated with Kaiser Permanente.

Read more on how to research and manage your health care costs:

MONEY best places to live

The 5 Best Places To Find a Spouse With a Job

141003_BPL_SpouseWithJob
A bride and groom on a beach at the water's edge in Kirkland, Washington. Kirkland is a top place for both men and women to find a spouse. Design Pics Inc.—Alamy

Looking for that special someone? Hoping he or she will be gainfully employed? Here's where to start your search.

There are lots of things to consider when choosing a place to live. How’s the job market? How much do people make? How affordable is it? And for those looking for love, the real question is: “Where are all the nice, single guys/girls?” And on that count, Pew Research might be able to help.

On Thursday, the data firm released a list of the country’s major metro areas with the highest ratio of employed, young (25-34) single men to young women, and vice versa. Pew included employment status based on the results of a recent poll, which found that 78% of never-married women think having a spouse with a steady job is “very important” (only 46% of never-married men agreed). The interactive map, available here, is a nationwide guide to the places where you have the best odds of finding an eligible bachelor or bachelorette.

But while we now know where the singles are, Pew doesn’t give us any clues about whether we’d actually want to live in any of these locations. That’s where MONEY’s Best Places data comes in. We’ve cross referenced our list of America’s best small cities with the new report, looking for cities that fall within Pew’s top major metro areas for finding love. Or at least a good shot at getting hitched.

The Top Five Cities For Those Interested in Men:

Castle Rock, Colo.

Best Small Cities rank: 4

Pew Metro Area rank: 2

# of employed single young men for every 100 single young women: 101

Maple Grove, Minn.

Best Small Cities rank: 2

Pew Metro Area rank: 4

# of employed single young men for every 100 single young women: 98

Eagan, Minn.

Best Small Cities rank: 2

Pew Metro Area rank: 4

# of employed single young men for every 100 single young women: 98

Kirkland, Wash.

Best Small Cities rank: 5

Pew Metro Area rank: 5

# of employed single young men for every 100 single young women: 92

Reston, Va.

Best Small Cities rank: 10

Pew Metro Area rank: 7

# of employed single young men for every 100 single young women: 92

 

The Top 5 Cities For Those Interested in Women:

Kirkland, Wash.

Best Small Cities rank: 5

Pew Metro Area rank: 1

# of employed single young women for every 100 single young men: 78

Reston, Va.

Best Small Cities rank: 10

Pew Metro Area rank: 1

# of employed single young women for every 100 single young men: 78

Newton, Mass.

Best Small Cities rank: 15

Pew Metro Area rank: 6

# of employed single young women for every 100 single young men: 74

Brookline, Mass.

Best Small Cities rank: 21

Pew Metro Area rank: 6

# of employed single young women for every 100 single young men: 74

Columbia/Ellicott City, Md.

Best Small Cities rank: 6

Pew Metro Area rank: 7

# of employed single young women for every 100 single young men: 74

 

More Best Places:

 

TIME Crime

The Boston Marathon Bombing Trial Will Stay in Boston

Boston Marathon Bombing
This photo released April 19, 2013, by the FBI shows Boston Marathon bombing suspect Dzhokhar Tsarnaev AP

Judge denies defense request to hold proceedings in another state and says that finding an impartial jury in Massachusetts is possible

The defense’s request to move the alleged Boston Marathon bomber’s trial outside Massachusetts has been denied by a federal judge in Boston, who did not agree with the contention that finding an impartial jury in the state would be impossible.

The judge did grant a request to delay the trial — but by two months only and not the 10 months the defense team had asked for.

The trial is now set for Jan. 5, 2015, at the federal courthouse in Boston — about 2 miles from the Boston Marathon finish line, where two pressure-cooker bombs detonated on April, 15, 2013, killing three people and wounding more than 260 others.

Lawyers for 21-year-old Dzhokhar Tsarnaev — who is accused of leaving the bombs at the race, as well as of shooting to death a Massachusetts Institute of Technology police officer while seeking to evade arrest — suggested that more than a year of aggressive media coverage of the bombings had made it impossible to recruit an impartial jury.

But Judge George O’Toole found on Wednesday that Massachusetts, home to 5 million people, afforded sufficient opportunity.

“It stretches the imagination to suggest that an impartial jury cannot be selected from this large pool of potential jurors,” he wrote.

Tsarnaev faces 30 charges, some of which carry the death sentence. His lawyers have contended that his older brother, Tamerlan Tsarnaev — who was killed in a shoot-out with police after the bombings — was a dominant, persuasive force in the younger brother’s life and the true mastermind of the attacks.

O’Toole’s 10-page decision leans in part on precedent set in the 2006 trial of Enron’s CEO, Jeffrey Skilling, who lost his bid to move the proceedings out of Houston.

The judge said the decision in that case rested different factors including the size and characteristics of the district and the quantity and nature of the media coverage.

O’Toole said that although media coverage of the Tsarnaev case had been “extensive,” it had not “been so inflamed and pervasively prejudiced” as to make it impossible to find a fair jury in the state.

He also said that jurors were not required to have never heard about an alleged crime before entering the courtroom, but were asked to judge the accused purely on the evidence presented in court.

“It is doubtful whether a jury could be selected anywhere in the country whose members were wholly unaware of the Marathon bombings,” said O’Toole. “The Constitution does not oblige them to be.”

TIME 2014 Election

Cosmopolitan Ditches ‘Sexiest Man’ Scott Brown in Senate Race

Scott Brown
In this Sept. 12, 2014 photo, Republican Senate candidate Scott Brown speaks during a campaign event at the University of New Hampshire in Durham, N.H. Elise Amendola—AP

Does he get no thanks for posing nude back in '82?

Cosmopolitan is “picking brains over brawn” in the 2014 Senate race in New Hampshire: the magazine is endorsing not Scott Brown, its 1982 “Sexiest Man in America,” but his competitor, Democrat Jeanne Shaheen, the magazine said Tuesday.

“While we wish we could support the man who once posed nude in our pages, his policy positions just aren’t as solid as his abs were in the ’80s,” Cosmo said of the Republican candidate, a onetime Senator from Massachusetts who has decamped to the Granite State.

Cosmo added that Brown lagged behind incumbent candidate Shaheen in clarifying his positions on key women’s issues, including access to reproductive care.

“Brown said he disapproved of cutting family planning funding, but also supported a bill to defund Planned Parenthood,” Cosmo said. “And when reporters tried to ask him about his views on contraception access, he literally hid in the bathroom to avoid answering the question.”

In June 1982, Cosmo ran a two-page centerfold of a beaming, naked Brown, the winner of its “Sexiest Man in America” contest and then a 22-year-old law student at Boston College.

Two decades later, when Brown was a Senator and running for re-election in Massachusetts (he lost to the liberal Elizabeth Warren), Cosmo again lauded him as looking “pretty damn good for his age,” quipping “Vote for Brown. He Has One Hell of a Stimulus Package.”

Polls in New Hampshire have shown a tight race between Shaheen and Brown, who appears to be buoyed by the state’s discontent with President Barack Obama.

TIME 2014 elections

Losing Among Women, Republican Scott Brown Offers Them Awards

Scott Brown Campaign Rally
Former Sen. Scott Brown, candidate for U.S. Senate in New Hampshire, holds a campaign town hall rally at the Pinkerton Academy in Derry, N.H., on Aug. 18, 2014. Bill Clark—CQ Roll Call/Getty Images

The recipient is puzzled and embarrassed by the honor

Janice Leahy, a small businesswoman in New Hampshire, still doesn’t understand why Republican senate candidate Scott Brown gave her a “hero” award when they met in May. “I’m an ordinary person,” Leahy tells TIME. “I’m no hero. I don’t look at myself as person of stature or significance or anything else.”

Armed with spreadsheets, Leahy had met with Brown at a diner in Windham to talk about the burden of Obamacare on her small software and professional services businesses. That’s when he presented her with a polished black plaque, emblazoned with the words, “Women for Scott Brown.” A press release followed. “I’m pleased to award Janice with a Hero Award to celebrate her determination to maintain a business despite government red tape and burdensome regulations that make for a very tough environment not only for women-oriented businesses, but for everyone,” Brown said in the statement. “That’s why I support full repeal of Obamacare.”

Leahy, a Republican, says she was left confused and embarrassed by the whole episode. She also says she is not sure she will vote for Brown in November, given his 2012 vote against an equal pay bill, an issue close to her heart given that she works in a male-dominated industry. “I’m not happy about his vote against it and I would need to know more about it before I vote for him,” Leahy says. “I haven’t decided yet which way I’ll vote in November.”

The episode is emblematic for Brown, who has been struggling to connect with women in his bid to unseat Democrat Jeanne Shaheen. Although Brown and Shaheen are neck-and-neck in polls overall—with Brown garnering 44% of likely voters to Shaheen’s 46%—Brown is losing women to Shaheen by 39% to 53%, according to an Aug. 21 WMUR Granite State poll.

He has tried to chip away at this deficit on the campaign trail. Brown’s campaign defines “The Women for Brown ‘Hero’ Awards” as commendations “meant to recognize individuals who are contributing to the economic life of New Hampshire, helping our community thrive and building strong families, sometimes despite adverse circumstances.” Emails to the campaign asking about how the honorees are selected went unanswered.

The awards have been timed to underscore policy talking points the campaign has sought to spread. The second plaque was given to Naswa Resorts owner Cynthia Markis and her mother, Hope, for operating their business despite high energy and Obamacare costs. And Brown gave a third award to Commandant Peggy LaBrecque, who runs the state’s only longterm care facility for veterans, on Veterans Day, using the event to highlight a package of veterans policy initiatives he unveiled that day. Repeated calls for comment to Markis and LaBrecque went unanswered.

Shaheen is the first woman in U.S. history to be elected both governor and senator. If Brown loses, he’ll also make history: He’d be the first man to lose two Senate races to two women. In 2012, he lost his Senate seat in neighboring Massachusetts to Elizabeth Warren. Shaheen’s campaign says Brown’s awards are patronizing towards women. “New Hampshire women aren’t looking for plaques, they are looking for a Senator who stands up equal pay for equal work and protecting access to basic health services like mammograms —and Scott Brown has proven he can’t be trusted to do that,” says Harrell Kirstein, a Shaheen campaign spokesman.

Brown’s challenge is shared by Republicans across the country. Unlike 2010, the GOP wave year when Republicans won the female vote for the first time since Ronald Reagan, women have helped Democrats stay competitive so far in several races across the country this year, including New Hampshire, North Carolina and Louisiana. Democrats have made a concerted effort to appeal to female voters, hoping to avoid another wave of losses like in 2010. They’ve introduced a women’s economic agenda and have repeatedly hit Republicans for waging a ‘War on Women,’ over access to abortion and contraceptives.

Leahy says she now sees the award as a thing meant to mean more for Brown than her. “I think it’s his push to show women in the area he understands inherently their issues, what’s near and dear in their hearts,” Leahy says.

But she noted that Brown has a tough task ahead of him, given the pride the state now has in having an entirely female Congressional delegation, which includes Brown’s rival Shaheen. “I do think it’s the coolest historical thing that we have full female congressional delegation,” Leahy said. “Being a woman, I like that that’s brought to the forefront all the time.”

TIME weather

Tornado Does Damage to Revere, Mass.

“Given the magnitude of the storm, it’s really a miracle that no one sustained more serious injuries,” Revere Mayor Dan Rizzo told the Associated Press.

A storm that swept through the Boston area Sunday night hit the coastal city of about 53,000 people, leaving felled trees, shattered windows and rattled residents.

 

TIME politics

Supreme Court Doesn’t Understand What It’s Like to Be a Woman in This Country

Planned Parenthood On Commonwealth Avenue
Self-described "Right to Lifer" Ray Neary stands behind the yellow line as he protests outside of a Planned Parenthood on Commonwealth Avenue in Boston, Mass. on June 26, 2014. (Photo by Jessica Rinaldi/The Boston Globe via Getty Images) Boston Globe—Boston Globe via Getty Images

Without a buffer zone, protesters' expression of free speech outside of healthcare centers has included chaining themselves to medical equipment and blocking access to healthcare centers.

On Thursday, the U.S. Supreme Court struck down a Massachusetts law establishing a protected zone around healthcare centers providing abortion. We at Planned Parenthood are disappointed with the Court’s ruling, which shows that far too many people — including far too many powerful people — don’t understand what it is like to be a woman in this country who simply wants to make her own healthcare decisions in private without harassment or intimidation.

Indeed, this is a ruling against the safety of women receiving basic health care. It is a ruling against the protection of staff workers trying to get to their job without being screamed at and facing the threat of violence. Though this type of threatening behavior is rare outside reproductive health centers, when it does happen it is frightening — and that is why patient protection zones are so important.

Despite this discouraging decision, Planned Parenthood will continue safeguarding our patients. The good news is that many patient protection laws across the country remain intact. Our patients and staff will continue to be shielded by the federal Freedom of Access to Clinic Entrances Act. In Massachusetts, Planned Parenthood is working with the governor, the attorney general’s office and local law enforcement to ensure that, in spite of this ruling, the privacy and safety of every patient accessing health care and every staff member doing his or her job will remain safe — no matter what.

With all due respect to the Justices, they have erred in invalidating the buffer zone as an impermissible regulation of speech. Protesters always have had ample opportunities to express their opinions directly to patients and staff. And the Court also distorted reality when it focused on supposed “caring” conversations from protesters.

In Massachusetts, before the buffer zone law was enacted, patients and staff were often subjected to intense and aggressive harassment. Planned Parenthood in particular was routinely singled out by protesters who went beyond expressing themselves through conversation. They disrupted the operation of health centers by chaining themselves to medical equipment. They stood shoulder-to-shoulder in the doorway of our healthcare centers, blocking access for our patients and staff. They screamed directly into the ears of patients, jarring them at a sensitive moment — when they were en route to a private medical appointment.

This volatile, unsafe environment in Massachusetts paved the way for tragedy. In 1994, a man barged into the Planned Parenthood health center in Brookline and opened fire, murdering one staff member and injuring three others. He then went to another nearby health center, murdering another staff member and wounding two others.

When the law was enacted, it was instantly clear that it worked. The atmosphere outside Planned Parenthood health centers became transformed to one of peaceful coexistence. Speech was never prevented outside healthcare centers. The only restriction protesters faced was to stand 35 feet away from the entrance of a healthcare center. Thirty-five feet is roughly the length of a school bus. When someone screams “Murderer!” from a distance of 35 feet, you hear the message loud and clear.

In short, the Massachusetts buffer zone law defused tensions and reduced violence because it struck the appropriate balance between preserving free speech rights and protecting public safety. It has proven to be an effective and balanced solution.

Americans are accustomed to buffer zones. They are erected outside Election Day polling places to protect voters. In fact, the U.S. Supreme Court has its own buffer zone to protect the safety and dignity of the Court, but the Court was silent on its own buffer zone in this decision. Apparently, women and staff do not deserve the same protection.

With or without a buffer zone, Planned Parenthood will work to keep our patients safe. One tool has been taken from us, but we have others at our disposal. We will ensure our patients can continue to make carefully considered, private medical decisions, without running a gauntlet of harassing and threatening protesters.

This decision is not the end of the story. At Planned Parenthood we continue forward in our relentless commitment to enable women to make their own healthcare decisions without fear, judgment or intimidation — and that will never change.

Cecile Richards is the president of Planned Parenthood Federation of America.

 

TIME Environment

Invasive Beetle Poised to Spread Into New Hampshire

Emerald ash borers strip nutrients and kill ash trees within a year

New Hampshire residents fear an ash-tree beetle infestation may spread throughout the state after forest officials found a swarm of the highly destructive invasive bugs in Salem, Mass., not far from the state border.

New Hampshire entomologist Piera Siegert says the infestation will likely spread north soon, although the beetles have not yet been spotted within her state, the Associated Press reports. Towns that could soon be infected include Hudson, Kingston, Londonderry, Hampstead, Pelham, Salem, Derry, Windham, Plaistow, Sandown, Danville, Atkinson and Newton.

The beetles, known as emerald ash borers, have already ravaged ash trees throughout Massachusetts — stripping nutrients and killing specimens within a year. Siegert warns that if the beetles are indeed found in New Hampshire, there will be an official quarantine on transferring firewood and ash-wood products.

[AP]

MONEY

What It Costs to Live in America’s No. 1 Place to Live

Sharon, Massachusetts, was ranked no. 1 on Money’s Best Places to Live. This New England town is surrounded by a wealth of good jobs in Boston, Providence, and the Route 128 tech corridor, which shielded Sharon from the worst of the recession. From a cup of joe to a tank of gas, here’s what things cost in Sharon, Mass.

MONEY

Play in a $3 Million Sherwood Home

The town of Sherwood, Oregon, was ranked by Money as no. 5 on the Best Places to Live.

This quaint historic town – known for its top-ranked schools and relatively affordable home prices – offers a plethora of fun for adults and kids alike.

The home featured in this video has a tanning room for those sunless days and a kids’ entertainment level, with a stage and built-in slide. Check it out in Sherwood, Ore., no. 5 on Money’s Best Places to Live.

Your browser, Internet Explorer 8 or below, is out of date. It has known security flaws and may not display all features of this and other websites.

Learn how to update your browser