Breaking up muscle knots, without completely breaking your budget

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Sometimes, there’s nothing like a good massage.  Exercise and stretching are incredibly important, but sometimes you really just need someone to dismantle the knots that have taken over your muscles, and give your body a “reset.”

Unfortunately, if you’re dealing with a chronic condition, the cost of things like massage, acupuncture, and other bodywork can add up quickly.   How you can you pay for these things without completely ruining your budget?

Here are some of the best strategies I’ve learned over the years for using your money as effectively as possible to get the help you need.

*Before booking anywhere, look the place up on Yelp to see if other people had a good experience there.  This is especially true if you’re following my next tip:

*Check websites like Groupon and Living Social.  Many massage therapists post deals on these sites to try to bring in new clients.  I’ve saved a lot of money and met some interesting, helpful people this way.   I’ve also seen people start to post deals for other types of therapies, such as acupuncture and chiropractic.

*Check the massage therapist’s or business’s own website.  A lot of places offer a discount to first-time customers, or a monthly special.  (Many also offer a discount for people who book multiple appointments, but leave that until after you’ve had at least one massage there).

*Check to see if your insurance company will help you pay for massage.   Some companies, at least in the US, will pay for about 15% of the cost of your massage, if you go to someone that’s in-network.

*Ask if there is a sliding scale.  Sometimes people in the helping professions offer a “sliding scale” to those with financial difficulty.  It isn’t something they always advertise, however, since they (quite understandably) don’t want to be taken advantage of.

This is sometimes an awkward conversation, but if it’s the difference between you getting help or not, it can be worth asking.

*Try to find a massage school near you that runs a student clinic.

Massage students have to perform a certain number of hours of massage before they can be licensed.  Most massage schools operate a student clinic where members of the public can come and get a discounted massage performed by a student.

This probably won’t be a spa-like experience.  You might end up sharing a room that has multiple massage tables in it with other people.   But it is a way to get a low-priced massage, without having to book too far in advance.  (Thanks to Jezzybel for this suggestion!).

*See if you can find a physical therapist who specializes in massage. 

Unfortunately, not all physical therapists consider massage to be an important part of treatment.   Some PT’s haven’t had very much training in it.  Others are discouraged from performing massage on patients by the companies they work for because insurance companies do not reimburse as much for massage.  But once in a while, you’ll find a PT who considers massage to be an important part of treatment, and whose place of employment allows him or her to perform it.

I am currently seeing a physical therapist who specializes in massage, and it’s incredibly helpful, convenient, and cost-effective, as my insurance company pays for most of it.  But it took me forever to find her.

Unfortunately, there is no obvious way to find a physical therapist like this.  I would suggest looking for someone who mentions manual therapy or soft tissue release among their techniques.

*Check out Community-Oriented Businesses

I’ve come across a few really awesome places over the years which follow a slightly different model than the traditional spa or health center.

Many of them have had the word “community” in their name, and they place an emphasis on being affordable and accessible to everyone.   These types of places generally offer a sliding scale upfront—everyone pays what they can.

I make it a policy not to post the names of businesses I currently frequent.  (Maybe I’m being paranoid, but the internet freaks me out).

I am, however, comfortable posting the names of businesses in places I no longer live, so here is a place I went for acupuncture when I was in college.  You can check this out as an example of a community-oriented business, and see how it’s a little bit different from other places.

http://amherstcommunityacupuncture.com/welcome.html

Many businesses that follow the community model offer other services, such as massage, counseling, and nutrition therapy.

*Self-Help Techniques for Muscles

Of course, there are plenty of things you can do for yourself to help ease muscle pain and prolong the length of time you are comfortable between appointments (for example: ice packs, heating pads, and self massage with a tennis ball and other tools).  However, there is so much to say about this that it will have to wait for another post!

Thank you to Foundry Park Inn for the use of the above photo!

Why do some hospitals get away with charging such exorbitant prices?

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The Center for Medicare and Medicaid Services published a ground-breaking report yesterday looking at the average prices charged by 3,000 U.S. hospitals for the “top 100 most frequently billed charges.”

The report shows that different hospitals appear to charge wildly different prices for the same procedures, seemingly without any rhyme or reason.  While one hospital might charge $5,304 for a hip replacement, another might charge $223,373.

While it’s true that the same types of procedures can be more or less intensive depending on whether or not the patient experiences complications, this study was based on an averaging of costs.  This means that the data is unlikely to be skewed by patients with complications.

Here are a few more choice pieces of data, as summarized by the Washington Post:

  • For heart failure with major complications, the average price ranged from $13,960 at one hospital to $75,197 at another.
  • For kidney failure with major complications, the average price ranged from $16,366 at one hospital to $80,919 at another.
  • To treat esophagitis and digestive disorders, the average price ranged from $7,107 at one hospital to $37,750 at another.
  • The prices charged by for-profit hospitals to Medicare were, on average, 29% greater than the prices charged by nonprofit or government hospitals.

Unfortunately, I wasn’t too surprised by some of these findings.  I think that, at this point, pretty much everyone knows someone who’s been screwed over by a crazy hospital bill.

One example is this story about Robert Reed, a patient who was charged $1,525 by a hospital he had not even been to.  Reed had had a procedure performed by a dermatologist who was affiliated with the hospital, but whose physical office was 1.5 miles away.  The doctor only charged $354 for her services, but the hospital charged $1,525 in fees for an “operating room” and “facility” Reed had not even been to.  This kind of price inflation is legal, and it happens all the time.

If you ask me, this is the problem with the American healthcare system.  Until now, medical institutions have been able to keep their prices a secret.

I can’t think of any other industry where it’s legal to keep the price a secret from the consumer until after he or she is legally obligated to pay it.  Buying clothes at a store?  There’s a price tag on them.  Getting your hair cut at a salon?  There’s a sign on the wall with prices on it.  Buying a car?  There’s paperwork to fill out once you and the salesperson have come to an agreement.

Now, to be fair, the prices hospitals list for various procedures are often much higher than the prices individual patients are asked to pay.  For one thing, many insurance companies have their own special “agreements” with hospital networks.  I see this on my own medical bills all the time: the first few lines represent the “actual” price which the hospital would like to charge, and the next few lines show what is called the “allowed” charge—in other words, the special deal my insurance company worked out as part of its contract with the hospital.  As the subscriber, the price I pay is based off of the “allowed” charge, not the much-higher “actual” charge.

But as you can see from the Center for Medicare and Medicaid services report, these “special agreements” don’t do much to level the playing field in the long run.  When hospitals are able to inflate their charges to Medicaid and health insurance companies by tens of thousands of dollars, we all pay in one way or another.

Regardless of where you stand on the political spectrum, it should bother you that up until now, hospitals and other medical institutions have been able to ride roughshod over the consumer.  If you’re inclined to defend these hospitals out of a belief in the “free market,” I’d like to point out to you that it’s not a free market when consumers are unable to make informed decisions.  If we are going to rely on competition to reign in cost, consumers need to be able to know the estimated cost before they undergo a medical procedure.

This report was step in the right direction, and I am cautiously optimistic about the future.  The Center for Medicare and Medicaid Services says that the report is part of an increased push for transparency in the healthcare industry on the part of the Obama administration.  I think we can all agree that the price discrepancies shown this report are totally ridiculous.  Private hospitals may have the legal right to set their own prices, but we as consumers ought to be able to know what those prices are, just as we would for any other purchase.

**Money picture published by 401 K (2013) under a Creative Commons license.