A new service has launched in Washington State. PriceDoc is a new website which allows you to shop providers for the best deals for a number of services. It also allows a limited soft of bidding when you can name your highest price and providers (doctors) can bid for your services. I think it is a very interesting idea and fits the spirit of the retail healthcare delivery model.
I encourage you to check it out.
[From PriceDoc - Better Price + Better Healthcare.]
The Atlantic publishes an interesting discussion of retail pricing failure in the healthcare system. You are encouraged to read the entire article:
For that matter, try discussing prices with hospitals and other providers. Eight years ago, my wife needed an MRI, but we did not have health insurance. I called up several area hospitals, clinics, and doctors’ offices—all within about a one-mile radius—to find the best price. I was surprised to discover that prices quoted, for an identical service, varied widely, and that the lowest price was $1,200. But what was truly astonishing was that several providers refused to quote any price. Only if I came in and actually ordered the MRI could we discuss price.
Several years later, when we were preparing for the birth of our second child, I requested the total cost of the delivery and related procedures from our hospital. The answer: the hospital discussed price only with uninsured patients. What about my co-pay? They would discuss my potential co-pay only if I were applying for financial assistance.
Keeping prices opaque is one way medical institutions seek to avoid competition and thereby keep prices up. And they get away with it in part because so few consumers pay directly for their own care—insurers, Medicare, and Medicaid are basically the whole game. But without transparency on prices—and the related data on measurable outcomes—efforts to give the consumer more control over health care have failed, and always will.
Here’s a wonderful example of price opacity. Advocates for the uninsured complain that hospitals charge uninsured patients, on average, 2.5 times the amount charged to insured patients. Hospitals defend themselves by contending that they earn from uninsured patients only 25 percent of the amount they do from insured ones. Both statements appear to be true!
How is this possible? Well, hospitals bill according to their price lists, but provide large discounts to major insurers. Individual consumers, of course, don’t benefit from these discounts, so they receive their bills at full list price (typically about 2.5 times the bill to an insured patient). Uninsured patients, however, pay according to how much of the bill the hospital believes they can afford (which, on average, amounts to 25 percent of the amount paid by an insured patient). Nonetheless, whatever discount a hospital gives to an uninsured patient is entirely at its discretion—and is typically negotiated only after the fact. Some uninsured patients have been driven into bankruptcy by hospital collections. American industry may offer no better example of pernicious “price discrimination,” nor one that entails greater financial vulnerability for American families.
[From How American Health Care Killed My Father - The Atlantic (September 2009) ]
If you are on a high deductible plan or an HSA (Health Savings Account) plan you may be able to save big by paying Cash for your healthcare services.
Next time you visit your doctor or dentist ask them what kind of discount you can get for paying cash on the spot. Remember, they might knock off 3% or more if you choose your debit card rather than your credit card.
If you are really savvy visit some of the great clinics that provide online price sheets like ZoomCare and use the published prices to negotiate deeper discounts.
You should always ask that you get at least a comparable discount to the insurance company when they negotiate the network rates.
Today, providers are many times incapable of providing the total cost of services.
Why?
Well, most times a procedure (or surgery) is make up of multiple parts and is delivered by multiple organizations. For example a tonsillectomy may include services from a hospital, an anesthesiologist and a ear/nose/throat surgeon. Add up the 3 bills you get and you get a total cost. Unfortunately not one of the three parties can give you a complete price quote.
This is where bundled services come in. What we need is mandated bundles and published pricing for those bundles by the providers not the insurance companies. Then, you can find the best price by shopping a retail model. Perhaps even negotiate. Finally, you can use your insurance to apply a discount. Easy.
Ask your elected official for real healthcare reform. Ask them to force providers and pharmaceutical companies to publish their prices and to stick by them.
You may have seen people comment about this problem before. You may have experienced it yourself. It goes like this....
You: "Umm, excuse me I am just wondering how much it is going to cost for procedure X?"
Provider Front Desk: "Shock...."
Provider Front Desk: <Inner Voice> "Oh oh, someone is asking what things might cost."
Provider Front Desk: "Well, I can try to give my best guess, but given your benefits, current deductibles, not to mention..."
You: "No, I just want to understand the price for the service?"
And on it goes... while they explain to you they can't be sure what the facility you have procedure X done in might charge, or the other providers who might participate in the procedure. Or, what happens if there are complications?
Amazing isn't it. A system like Healthcare, where everyone is talking about cost but you can't even find out what things cost.
