New national database of healthcare prices is now publicly available, tracking pricing trends locally, regionally and nationally, on a monthly basis
NEW YORK, Aug. 29, 2022 /PRNewswire/ — Beginning today, journalists, analysts, policymakers and others with a keen interest in understanding the true price of common health care services nationally, regionally and locally, now have a useful tool to do so: the U.S. Health Care Price Index (USHPI).
The USHPI is the first national resource to publicly document the price of cash-pay medical care in America.
The USHPI is the first national resource to publicly document the price of cash-pay medical care in America specifically for journalists and other interested parties. It features real pricing data for routine medical services in all 50 states – from primary care and mental health to women’s health and more – with additional prices and specialties to be added over time. In addition to regional and state comparisons, the USHPI tracks price variance and market trends on a monthly basis.
Until now, pricing data for health care services has been opaque and largely out-of-reach; now, just like price databases for commodities like gasoline, air travel and insurance, there is a database for understanding the recent cash price of a COVID screening visit, urgent care and many other medical prices in any state or region.
The entire USHPI database of monthly cash prices for June and July 2022 can be found here: www.sesamecare.com/compare/ushpi.
WHAT IS THE CASH PRICE OF MEDICAL CARE?
Simply put, the cash price is what a doctor or health care provider charges a consumer when a third-party payer – like insurance or a government entity – is not involved in the transaction. This could be because a patient does not have insurance, is underinsured or chooses to pay their provider directly, without involving a middleman.
WHAT ARE EXAMPLES OF RECENT CASH PRICES?
In July, the average cash price of a primary care appointment in the United States, with a doctor or nurse practitioner, was $45 (Wyoming was the lowest at $39, South Dakota was the highest at $93). Regionally, the Mid-Atlantic, Northeast and Midwest paid just above the national average, ranging around $47–$48, whereas patients in the South and West paid below average ($43–$44).
The Inflation Reduction Act is shining a much-needed light on the price of prescription drugs (and what they could look like in the future). Americans who paid cash for a prescription refill appointment paid an average of $44 over the course of June and July.
When it comes to specialty care, the national average price for a mental health consult was $47 in July, down from $48 in June. Prices ranged from $36 in Washington to $169 in Connecticut.
COVID screenings in June averaged $44 nationally, rising to $45 in July. Most affordable COVID appointments were in Illinois and Florida in July, at $36 and $38, respectively; states paying the most that month were Tennessee ($55) and Missouri ($63).
WHAT IS THE METHODOLOGY USED TO COLLECT THE DATA?
The data comes from Sesame, one of the largest cash-pay health care marketplaces in the United States. It covers the thousands of healthcare providers resident in the marketplace that charge cash prices for their services. Sesame analyzed thousands of primary care and specialty care appointments made on its platform, leveraging pricing data for actual patient appointments that occurred during June and July 2022.
Sesame is building a radically new healthcare system for Americans who are uninsured or otherwise priced out of everyday care. The company’s marketplace replaces historically inefficient, expensive healthcare with a direct connection – either virtually or in-person – between patients and physicians. This direct connection enables Sesame to offer doctor visits, labs, imaging and prescription drugs at half the price. Founders include a Harvard Ph.D. in health policy and economics; a former Goldman Sachs analyst; and entertainment executive and healthcare reformer David Goldhill, author of the legendary cover story in The Atlantic, “How American Health Care Killed My Father.” Sesame has raised $75 million so far from investors that include GV, Virgin Group and General Catalyst. The company was ranked #1 by Healthline for overall care in 2021 and 2022. For more information, please visit www.sesamecare.com.
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