Diane Hess.j26.jpg

Diane Hess is executive director of the Central Penn Business Group on Health, an affiliate of the Lancaster Chamber. 

A constant theme in many of my past articles was to implore readers to make educated decisions about their health care.

I’ve written about everything from asking questions about recommended care to choosing more cost-effective providers and determining whether care is really necessary. It never sounded that difficult to do, right?

With technology at our fingertips that gives us access to doctor and hospital ratings and tools that give estimates of cost, why aren’t more people practicing what I preach?

Unfortunately for me, I now know the answer to that question — it really is not that easy to practice what I preach.

My first challenge came when I went in for a routine health visit and my doctor recommended some blood work.

My doctor is now employed by a health system and when he asked if I was going to have the blood work done in the system, I meekly answered yes instead of letting him know I wanted to go to a free-standing lab to cut my costs since this would be an out-of-pocket expense for me.

I did gain a backbone at checkout though, so I was able to get my orders printed to take them to the lab. I felt so proud.

My next challenge came when I went in for another routine screen. As I entered the facility, the attendant leading me to the screening, indicated that I could have a more extensive version of the screening if I wanted, but there would be an additional charge not covered by insurance. I needed to let them know if I was willing to pay the upcharge myself.

As a conscientious consumer, I of course said no. I again felt proud until I was told that the basic screen found some abnormalities and I would need the advanced screen any way. So much for cost control.

Based on my results, it turns out more tests are needed. When the nurse called to review my next steps, she let me know she had scheduled my tests at health system facilities.

Again determined to be that enlightened consumer, I asked if she knew of a free-standing facility that could perform the tests. The nurse indicated that the approval for the tests was based on the use of that facility only.

If I wanted to investigate other options, it would be up to me to search, schedule my appointment and get back to her with the tax ID number for that facility so she could determine if it would be covered by my health insurance. It would also be up to me to gather all of my past results and bring them with me to the appointment since they are not easily shared outside the health system.

It seemed like a lot of work. But again, in an effort to practice what I preach, I went online to my carrier’s website to see what I could learn.

What I found is that although there is great variation in price for the service I need, I also would need to travel quite a distance to save. Now, in addition to cost, I would need to factor in the time value of money. Also, most of the facilities offering this test do not have any ratings listed.

On the other hand, the facility for which I am scheduled has a 4.5 out of 5 star rating. So not only do I need to consider cost, and travel time, but I also need to factor in that if I need additional care, I want to be in the best place I can be for the care I need. To that end, I have decided to stay in the health system for care.

Having gone through this exercise, I now understand better how challenging health care decisions are for consumers.

In order to make good decisions you need time and you need to be persistent in investigating all of your options. I also understand that there are many factors that need to be considered when making that educated choice about care.

As for me, even though I am going to have my care where I was originally scheduled, I know much more about what to expect and what it is going to cost.

• Diane Hess is executive director of the Central Penn Business Group on Health, an affiliate of the Lancaster Chamber.

What to Read Next