We’ve been yelling from the rooftops, promoting price transparency for the last three years. It has been assumed that showing patients how much their medical procedures cost will help drive down prices, improve patient consumerism and promote providers to offer affordable options. Providers across the country have jumped on board with the transparency plan, but there are a few roadblocks affecting the success of this bursting industry:
- Charges are not the same as prices
As consumers, we are trained to believe that when we see a price, that is all we will be charged for the product or service. In health care however, if you are able to find a price estimate for a procedure, that often does not take into account additional fees. Ex: Radiologist-reading fees at hospitals tacked on after the procedure
- Translating quality metrics into useful information can be subjective
Every patient is unique and rarely is one patient’s experience the same as another’s. Quality can be subjective when patients are judging a provider based on things like whether or not the nurse smiled or frowned and whether or not the patient was pleased with their diagnosis. To have true quality transparency, it needs to be clear that each provider is being compared apples to apples.
- Specialists and providers often bill patients separately for a procedure
Some providers are able to provide bundled payments, but when multiple specialists and providers are part of a patient’s experience they will often send multiple bills. For instance, if a patient is examining the cost of a surgical procedure they have to consider whether or not the anesthesiologist, the physician and their home health provider will charge them separately.
- Insurance payers have different pricing set for different care providers
Understanding what a patient in a high-deductible health plan is responsible for as far as charges versus an uninsured patient or someone electing to pay out-of-pocket really varies. On the same note, different insurance payers have varying contracted rates with care providers, so determining true costs across the bar gets confusing.
On SaveOnMedical.com, we list clear self-pay prices, meaning the price a patient would pay if they were electing to pay 100% out-of-pocket without insurance. More payers are looking for ways to reward their people for shopping around for lower priced options however, so we can also serve as a solution for those payers who have large populations of patients in high-deductible plans.
Transparency in health care can seem overwhelming, but we have taken steps to eliminate the roadblocks discussed above in the following ways:
- We include all fees in one price. This means no bills being sent to patients down the road for facility fees or interpretation fees.
- We have created a grading system for all of our providers in order to eliminate bias, grading providers on over 50 key points including everything from accreditations to technology to wait times to convenient parking.
- We have not added surgical procedures to our website (yet) but when we do, the payments will be bundled for patients. Save On Medical will then worry about divvying up payment among specialists. The simpler for the patient, the better.