A new resource is available for physicians to provide struggling patients. But could it hinder quality of care provided?
A patient is in your exam room and you know he is struggling to pay for his healthcare. Perhaps he has no job, a high-deductible insurance plan, or no insurance at all.
The situation is challenging enough, but when you need the patient to undergo lab or radiology tests, the scenario becomes more complicated. The patient’s money struggles may prevent him from securing the tests he needs, and therefore, hinder your ability to treat him properly.
“For a lot of us, we don’t know where to turn,” Show Low, Ariz.-based family physician Scott Hastings told Physicians Practice. “Doctors are kind of at a loss, they don’t know where to send them, [or] who has the best prices.”
Hastings, who said most of his own patients struggle to pay for healthcare, spends a lot of time negotiating lower rates with labs or imaging centers for his patients. He also said he knows he’s not the only physician doing so. That gave him an idea.
“There’s a lot of people out there outside of Show Low who need to get blood tests done, X-rays, mammograms, CAT scans - who don’t know where to go,” he said. “There are just a lot of outrageous prices in a lot of different places.”
With that high volume of patients in need of less expensive test, he realized, came bargaining power. So he launched BidOnHealth.com, a healthcare services website he compares to Priceline, the popular "name your own price" online travel service.
Here’s how BidOnHealth.com works: When a physician prescribes a routine laboratory or radiology test for a patient who is struggling to pay, the patient can visit the site, select the test he needs, and identify his geographic area.
If a lab or radiology testing site nearby offers the service at a discount (there are 1,600 sites that participate in 48 states) the patient can buy the test he needs at at least 60 percent off the average price. Or, he can bid on it for a lower price. Similar to a bid made on Priceline, the patient does not find out the testing location until after he has made a purchase. The site is geared to uninsured and underinsured patients and it doesn’t work with insurers directly.
Once the patient undergoes the test, his physician receives a fax with the results.
The website is controversial for some, who fear it pushes patients to value cost of care over quality.
For instance, Brian Baker, president of medical imaging consulting company Regents Health Resources, told AZCentral.com that there is a “huge difference in the quality and capability of technology.” And he added, "Just because a location offers low prices doesn't mean it is always the best quality."
But Hastings said critics of the site “don’t have a clue” about what it’s like to be in the trenches of the healthcare affordability battle.
“When you’re sitting down with somebody who’s going to lose their house, they can’t afford to feed their kids, and they’re struggling with trying to figure out how to pay … it really changes you,” he said. “If you’re not on this front line it’s easy to get caught up in, well this quality’s lower and whatever, but good grief, I’d much rather have [patients use BidOnHealth.com] than not know anything at all.”
And, Hastings argued, the services offered on the site are of no lower quality than services secured in other ways. “It’s the same exact lab, the same exact X-ray that you would get if you were to have insurance. There’s nothing low quality about it, all of the providers are accredited, they’re licensed,” he said.
Family physician Craig Koniver, a fellow Practice Notes blogger, said BidOnHealth.com sounds “intriguing,” regardless of the quality vs. cost debate.
“To me, many labs charge way too much for their services, so providing patients a resource to check on the cost of the lab services is a great idea,” he said via e-mail. “I see no problem with patients having the choice about how they spend their money. Even if a patient chooses to value cost of care over quality of care, isn't that the patient's decision?”
Of course, in an ideal world all providers and labs would provide similar care at similar costs, but that’s not the reality, said Koniver.
“I always want my patients to have options and to know exactly what they are paying for,” he said. “Unfortunately, the health insurance model, for the most part, blurs and distorts the costs of services which then ends up affecting the quality of care.”
Though the Supreme Court upheld the individual mandate in its recent Affordable Care Act ruling, Hastings said BidOnHealth.com will continue to be a useful tool for physicians and patients. There’s “still going to be deductibles to be met, there’s still going to be copays, and that’s really not going to affect our business,” he said.
What do you think of BidOnHealth.com? Do you think it will hinder or improve healthcare quality for those who use it?