Healthcare price transparency is slowly gaining ground as employers become more cost conscious, and consumers have to pay more out of pocket under high-deductible health plans. But a key missing link has been the ability of employers and consumers to obtain reliable information about quality as well as price.
Review sites have proliferated, but the ratings focus on factors such as customer service and wait times, rather than clinical quality and outcomes.
New York City-based Spreemo started in 2010, with a focus on helping employers and patients vet diagnostic imaging centers on quality and price. Radiology is a specialty where many consumers are able and willing to comparison shop.
As an experiment, Ron Vianu, co-founder and CEO of Spreemo, sent his mother, who had lower back problems, to three magnetic resonance imaging centers in New York City. She underwent three scans and received three different recommendations and treatment plans. “Most people think radiology is a commodity,” Vianu said. But, he added, “there's very little consensus about what goes into quality.”
Spreemo has developed software that helps consumers evaluate quality and costs. It collects extensive data from providers, from their accreditation to their protocols, such as how many pictures they take per scan. The company grades imaging centers based on how accurately they interpret scans, the types of equipment they use, and their turnaround time.
It has even launched its own Quality Research Institute that asks outside experts to develop consensus on what constitutes quality and to measure the impact on patient outcomes. The experts regularly review a random sample of scans from Spreemo's providers to complement the company's predictive modeling, with the idea that high-quality centers should have the least degree of variability. Spreemo's senior medical adviser, Dr. Richard Herzog, who directs spinal imaging at New York's Hospital for Special Surgery, heads the research institute.
Spreemo's current focus is on worksite injuries. Its main client base is large, self-insured employers and worker-compensation insurers. “Employers are very incentivized to get people better,” Vianu said. “If someone has less than optimal care, that's going to cost them.”
Providers that want to join Spreemo's referral network send their data to the company. Employers and third-party administrators use the data to match patients to imaging centers. The data are sortable by quality metrics, price and travel distance to the listed centers.
Radiology services have become price transparent at a faster rate than other medical specialties, according to a study in the Journal of the American College of Radiology published in April. Researchers found that nearly 80% of academic medical centers and private radiology practices were able to provide prices for a head CT scan without a contrast agent. Rates ranged from $211 to more than $2,000.