Five Reasons to List Medical Prices Online
Five Reasons to List Medical Prices Online
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While physicians typically shy away from listing medical prices on their website, there is a way to do it to ensure patients and practices are both winners.
In fact, there are several benefits for physicians if they are transparent with the prices to their services, said Jonathan Kaplan, a plastic surgeon at Pacific Heights Plastic Surgery, a practice based in San Francisco. Kaplan presented on pricing transparency at the annual Healthcare Information and Management Systems Society (Conference), held this year in Las Vegas.
In the past, providers have hesitated to list the prices of the medical services they offer — either on the practice website or sharing that information through mobile phone apps — because of three reasons. "[Physicians] are worried patients are going to price shop. They are afraid patients won't understand these are estimates and might change because of policy or the negotiated rates. They are also afraid competitors will be checking their prices," Kaplan said.
Yet, because of high-deductible health plans and patients paying more out-of-pocket expenses, Kaplan said this will become necessary for physicians to market their practices. "Even if patients are paying out of pocket for medically necessary services, they are still paying out of pocket," he said about the cost-conscience healthcare consumer.
Kaplan advocated providers should list prices in a way that will capture potential patient information. For his practice, this meant implementing a platform on his practice website that requires patients to fill out vital contact information before getting an estimate. This process, he said, has several potential benefits, which Kaplan shared at HIMSS16.
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Comments
This is why I am now a direct primary care physician. There is no conflict of interest or conflict with contracts. My membership prices are on my website and many services are included in the price. The only reason my individual a la carte prices aren't posted on the website for all to see is that I have been too busy signing up new members to stop and post the list! The government and insurance companies aren't going to lower the cost and improve the quality of health care. A strong, honest relationship that makes me accountable to my patients and my patients accountable to me is what makes me WANT to control costs. I WANT to do it because controlling costs is one of many ways I feel obligated to care for living, breathing people that I care about, not faceless bureaucrats, accountants, actuaries, policies, or computers. Cory Annis, MD; Unorthodoc.com
It is my belief that patients will ultimately demand to be educated - even if they're not asking for price information now. "Physicians" are worried that patients are going to price shop. They should be. If the information is not easily available, they'll go somewhere else anyway. As health care consumers, we do this now with other services (e.g., dental, veterinary); the day is coming when consumers begin to be more savvy about their own personal health expenses.
Posting a price list is not "transparent" at all, except for non-insurance cash pay patients. For insurance patients, our office has 20+ different fee schedules. Not only would that be extremely confusing for a patient, we would also be in breach of contract for most plans if we posted that information. Not to mention, it would be an open invitation for insurance carriers to lower their contract with the office if they are one of the higher negotiated payers. What practice would open themselves up for that? Also, our office's standard billed fee could be $100 for a specific CPT and another practice could have a standard billed fee of $200 for the same CPT. Depending on the insurance contract, it could cost the patients less to see the other office if they have one insurance and more to see us if they have another. How would that be "transparent" or not confusing? And with insurance, add multiple procedure discounts that are calculated when the claim is adjudicated and a published price list would be meaningless. Unless you are a cash-based practice only, this is not as simple of an issue as the article suggests. The only way to accurately quote for non-cash services is to handle with personal communication with the patient and even that assumes that you know the exact service being provided. This may work for plastic surgeon, but is not practical for most other specialties.
Typo correction to the above sentence: "Depending on the insurance contract, it could cost the patients less to see the other office if they have one insurance and more to see *them* if they have another."
@ Rebecca- You are precisely right. And you run very close to the Sherman Anti-trust Act which prohibits doctors from sharing their contract rates with other doctors. You can only really do this for cash pay patients, but even that is getting very close if you put it out on the internet for other doctors to see. As am administrator I think it is reckless to post articles like this without including the boundaries because not every reader of this magazine will know about the SAA or other contractual rules .
I am trying to understand this from a patient point of view. Recently I was seen by an opthamologist with my medical insurance and my procedure went entirely to deductible. If I understand this correctly I may charged more depending on what insurance I present with? So, if I present with insurance A instead of insurance B I may end up paying more out of pocket based on the insurance I present with? If I have no coverage for routine eye care I am then expected to pay more than any insurance contract would pay.
As a patient then I would like to see published fees based on my expected out of pocket based on my insurance plan. I as a patient would choose the provider that best suits my needs and potential out of pocket. I am not sure I understand as a patient why I am not allowed to price shop and understand what my responsibility will be after my particular insurance pays prior to services being rendered.
I know what I will pay for automotive services prior to work being done, my expected bill at the hair salon and even the dentist, and we all know the dentist has insurance contracts. I think physicians need to come around to this world being competitive and decide what the patient will ultimately be responsible for and be prepared to tell patients up front.
This was not posted by Kelli but actually by me. Just trying to bring a patient perspective on how patients would have such a difficult time understanding the medical profession.
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