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Let them chose. Some will remember the adage "You get what you pay for". Welcome price transparency. Welcome quality transparency. Legislate against fraud.
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Patients should be able to comparitively shop and health care providers should be able to charge what the market will bear.One may choose to pay more for a Lexus than a Toyota because it is better-no such opportunity in the health care market except private pay!
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I don't know how relevant it is to Psychiatric patients here in the NE...ie in Philadelphia and suburbs
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we should all be aspiring to excellence, safety and customer service. reducing health care to marketplace economics is demeaning and is a disservice to patients and physicians and hospitals alike.
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Patients have a right to know what services are going to cost.
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Prices in the VA healthcare system are already stablished and the veterans receive services based on their service
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This is not applical to me as I am not currently employed by a Health Care organization.I am, however an active healthcare consultant, having just moved from Joint Commision Resources to IPI-Healthy Hospital. As more of the financial resposibility for health care is transferred from employers to employees (Commercialization) Patientīs concern about cost increases. I think, and encourage, all health care organizations to provide Pricing information along with quality and outcome information to the publioc. There also needs to be public service education about how to interpret and understand this information.
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Medicare, Medicaid and Third Party Payors set their own fees which patients can request fom the carriers. If a patient asks for a Physicians fee it should be provided but I think shopping around for the lowest fee is not the best way to seek health care.
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Self pay patients are offered discount without asking if payment is made at the time of service. Labs are also offered at the practice rate in order to save the patient money and make it easier for them to make only one payment for their entire office encounter.
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Most of these questions are non-healthplan related.
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The expansion of health care services in India, Thailand, Dubai have prices available. In these foreign countries/cities, Johns Hopkins, Mayo, Harvard, Cleveland Clinic are all competing per price and type of medical care received.
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I have noted that patients tend to price shop more when they are cash paying for their services. For example, elective cosmetic surgeries have become an item people price shop on.
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Because of the a la carte fee for service system and the separation of professional and technical charges, it is often very difficult, even for professionals, to know exactly how much is charged for different procedures (when everything is taken into account). Certainly average charges are available for different diagnoses and are publicized in the HC4 website (for PA). Howver, this only covers the major diagnostic categories and does not necessarily take into account the severity index of the patient. For some diagnostic categories,some hospital might charge more but actually offer more in return with better service and outcome. Price transparency alone is not sufficient for patients to make their therapeutic decisions.
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With more people uninsured or paying more out of pocket, price transparency is absolutely necessary. It's time for the health care industry to recognie what consumers need and want.
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The more we move to universal coverage that basically pays for anything and everything, and prevents orgnizations from charging the patient directly, the less important this will be to the public. The less individuals are invested in the cost and consequences of their care, the less they care. I am also afraid that the information has much more potential to be used and abused by different provider organizations to essentially "fix prices" across the community and actually prevent competition and realistic costs for care.
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Prices are somewhat irrelevant since reimbursement is the key. So, sharing sticker prices of items is not meaningful.
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I think it is a good thing. However, I only hope it does not affect the quality of care patients receive.
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The risk of transparency from a Health Insurance company's perspective is that by posting prices (allowables) we enable our whole provider network to see what we reimburse other docs of the same specialty. Our concern is that this will potentially drive up costs because lower compensated docs will be able to view what their peers are being paid by CPT code
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of utmost importance for the future of affordable health care
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My practice is emergency medicine. This issue is complicated in that I personally believe patients have the right to price shop. However, in emergency medicine we must adhere to EMTATA regulations and federal laws to provide care to all patients regardless of their ability to pay. Which again I personally agree with. In institutions providing care to the indigent population without insurance or ability to pay the burden would fall on the smaller percentage of patients that could pay resulting in a disadvantage to the hospitals and EM physicians providing care at these institutions. Provisions must be made to account for these descrepancies. Hospitals will close.
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As a health plan executive who still practices on a part-time basis I think that transparency can be a good thing as long as some measurement of quality of outcomes is coupled with cost of care so that patients and those who pay for their care can determine value (=benefit/unit of cost)
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As long as someone else is paying not many folks care or understand the connection between price and their pocketbook
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Health care costs needs to be controlled and consumers need to be enlightened as to the the cost of their care - I am all for that. I am concerned, though, over the prospect of health care entering the competitive marketing arena at the consumer level - price competition, sales, other incentives to attract business - what's next? A free toaster or blender with every cholecystectomy?
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I think it is a business strategy whose time has come for implementation in our twenty-first century competitive health care market.However, the quality of health care must not be sacrificed in order to gain increased quantity of market share.
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shopping for some things might be OK although quality and complication rates might be at least as important as price
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It is important that patients are aware of what they pay for their services. However, it is also important that they know what is the cost of providing care in a Doctor's office. They should also know the quality of care they receive for the price they pay.
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No comment.
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The consumer driven health care market needs to understand that the real price shopping is done via the insurance industry. The industry has in place "price bumps" simular to the road bumps that are on some of our streets.
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Patients should be able to price shop but they should also be provided with outcome numbers and satisfaction numbers. Patients need to learn about "how to doctor/hospital shop".
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Prices are only relevant when the patient actually has to fund it - as providers, (hospitals and physicians), we only receive what the third party payor gives us, and what they (or the state) will allow in balance billing. In Massachusetts, where I practice, these limits are pretty clearly defined. The issue is not price so much as utilization, that small fraction of providers who are gaming the system, and the additional costs of defensive medicine.
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Health care has been provider centric too long. It is high time we became consumer centric. This is the moment of truth. Who are we truly here to serve?
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The problem with price transparency is that it ignores the complementary issue of code-use transparency. The provider with the lower prices may use more codes so that the same overall service actually costs more. Try asking a surgicenter how much a back surgery costs - they will ask you "what back surgery?" - single or multiple level laminectomy? What part of the back? With or without fusion? With or without diskectomy? What kind of hardware? Who is the surgeon? How long will it take?
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If you mean Charges not price, it is not relevent, we can price or charge anything, but actual payments from patents and payors is another.
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Pricing transparency is important to both the consumer (so they can choose cost effective health care) and the physician (payors MUST be forced to disclose what and how they pay- ahead of time- and must not be allowed to change in the middle of a contract). Physicians should be allowed by law to organize and bargain. When it is really a free market and every American understands the importance of having a personal physician (and HAS one!), then health care in America will improve.
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We raised our sliding scale when we discovered our competitors were charging more than we were.
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I believe that the grading system as well as information on price will drive health care.
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Important to have but in the Medicaid managed care world it is not an issue.
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Important to make sure there is "quality equivalency" with different prices.
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The direction we are going in is clear. What is a little less clear is the speed and distance we will travel.
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Price transparency in important in maintaining honesty on the part of the professionals. It should not be presumed by patients to be an important indicator of presence or lack of quality. I think most patients understand that.
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Nickel and diming cannot be overestimated, the cost of an MRI doesn't always include the add-ons. Until we package price, it is a gimmick.
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I can see right through it.
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Then, the clients will be buying healthcare services like their cars, their televisions,and shoes.... INFLUENCED by clever advertisements, price,etc...It looks like that the insurance Co/HMO will once again be the big winners... They will drive the price down, down
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you get what you pay for
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Price should be common info and shared.
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Price transparency in health care is long overdue!
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It should be transparent
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It is and will continue to be more prevalent
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The difficulty in pricing transparency is ensuring that the comparisons are valid. The total cost of the procedure, including facility, surgeon, anesthesiology, imaging, lab, etc. should be considered. This would need to be an industry adopted standard or the government must mandate the parameters. I also think that a quality indicator shoud exist side by side with the price quote. Does this mean a HealthGrades type report card? These are based only on the Medicare claims data, not necessarily the population that is actually price shopping. Lastly, when discussing quality, the procedure is not always an isolated event, but exists within the continuum of care. Care coordination within a multispecialty group practice with a single EHR is often a far greater value than a rock-bottom price on a single procedure. Knowing whether that procedure actually needs to be done is sometimes the question.
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there are too many other issues that are involved in healthcare that are not reflected or unable to be reflected by using price as a guide for where to have services provided.
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Certainly price transparency is important, but the quality component has to be factored in as well. Less expensive pricing with less than optimal quality doesn't do anybody any good. Poor quality initially can be the most expensive option longterm.
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It is remarkably hard, even as a physician, to find out the cost of care my patients are contemplating. This should be a standard bit of information and it boggles the mind to think it is not.
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Major problem has been with pharmaceuticals and our pharmacy trying to compete with Target and Walmart with the generic scripts. We do not have other products to compensate for this type of loss leader.
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The hospitals we work with do not release pricing info to patients (or have not in the past) and still seem reluctant to do so. They make it very difficult to obtain (this is in radiology specifically).
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As more pts opt for MSAs - this is a trend that will stay, especially for ancillary services. We are not seeing too much shopping for MD services yet in our area.
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I think that if a patient asks he should be given the price. Even more, I feel that the practice should make available information on willingness to alter prices or payments. Whether people whould be allowed to price shop is not just an economic question.Quality of care is not well measured and therefore not well advertised. The way people are handled by staff, although measureable is often not the inquiry some one who is price shopping is looking at. In Occupational medicine we deal with these attitudes all the time but it always comes down to service that the company owner acknowledges not necessarily the patient. Besides this, so what if the price is known, does the patient know a surgeon's missed AP rate, OB rate of C section how many diabetics have HgA1C below 6? I don't have an answer but I sure know that there are enough questions that make anwering much more difficult than asking.
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Highly desirable but pricing should be only one part of a more robust description of what is being purchased / received, i.e., outcome / quality measures
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This type of info needs to be chaperoned for patients to really gain understanding of what the pricing means
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With insurance adjustments, I have no idea how much a patient is going to be charged for my services, only that I will be paid less than my fee schedule.
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long time coming. when individuals have choices, better quality comes with lower prices.
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It seems that even armed with price information, patients will still have to go whereever their insurance has contracted services.
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Cost is getting way out of lineand price transparency will do two things: (1) bring more focus on costs, and (2) increase focus on quality measures because quality will suffer initially as costs go too low. The "unbundling" of costs we4 all saw in the hospital marketplace will now occur inthe outpatient center and with professional fees. The typical visit will be broken into multiple components with an individual fee for each component.
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Transparency is imperative for the proper maintenance of quality, improvement of quality and to engender confidence among end-users.
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By and large, the standard of care and quality of care, in general, should be stable enough by now within the U.S. to allow customers to move to the next phase of capitalism: supply and demand-driven health care economics. This is especially the case with the current level of regulatory controls, patient safety scrutiny and public visibility/accessibility of physicians' quality and practice data. Of course, the next level will drive a cottage industry of its own of organizations ready and willing to assist consumers.
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The biggest problem in transparency is that it is not transparent. How does the consumer know he is buying the same product? That is getting a bit easier with the advent of public reporting, but for the vast majority of care, one doesn't have access to meaningful, risk-adjusted ratings, unlike when buying a car or a camera.
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As with quality, price transparency must also be readily available to all customers. However, it must also be noted that most hospitals have little understanding of their cost structure and are likely to provide only charge information- which bears little resemblance to costs.
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We need to have price transparency, but it needs to be related to estimations of value in a format that the consumer can understand. For example, time back to work for episode of low back pain for $$.
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It would be nice if price were the determining factor, I suppose, but what ever happened to the doctor-patient relationship? Seems like it went away awfully fast!
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complex issues with questions that are too simple
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pricing transparency is and will become important as more of the cost of health care is shifted to the consumer. The converse maybe true if the political winds blow toward a one payor system operated by government agencies. Prices will then be set.
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Absolutely imperative that there is price transparency...This will increase competition to LOWER prices, and benefit the consumer. It will also improve the quality of the product on the market.
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The hospitals in our system are driving the cost.
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I think a better question is how much of a price difference would it take to entice a patient to travel significant distances the second time. For those of us in rural settings, price shopping could entail significant travel with its attendant loss of support structures for the patient and the family. The first time a patient travels it may be significantly price sensitive; the second time, they are more aware of the value trade-off involved and they may be willing to pay a higher price to keep their support structures intact. But how much higher?
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www.clarian.org
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Health care is a commodity - as long as there is adequate information on QUALITY as well as on price, the savvy consumer can make an informed decision.
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Would be fine there is some old Yiddish saying about shopping for everything except doctors
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We have prices posted for some products ie CDHP, but not others.
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Price transparency at the consumer level is meaningless unless it includes third party payer price/cost transparency.
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Good idea matched with evidence based medical guidelines. The risk is that it must address the preventive and chronic disease management aspects of care as well, not just episodic, acute care costs.
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A significant part of the problems with healthcare today have to do with lack of Leadership among physicians. Chances are iy will get worse before, maybe, getting better.
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There will always be a less expensive, lower quality product, health care being no exception.
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People who shop only on price risk bad outcomes. If it is cheap, it won't be fast and may not be good.
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Patients are mostly interested in quality (and personal interaction), while insurers are mostly interested in price. The insurers can MAKE patients more interested in price by emphasizing it, but that distracts everyone from true quality. The difficulty is actually measuring "quality" (how and what is it?) in a way that is accurate and long term. True, "quality" care will have a greater long term effect on cost than a focus on short term price transparency. (imo)
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While consumers should always have the ability to shop around based on price, it will require an extensive amount of education for the average citizen to understand why there are differences in the cost of healthcare between institutions.
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For health care to be market competitive, patients must be able to have access to price information.
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#5. If patients are price shopping, they need to know the quality of the treatments and procedures as well as the cost. Perhaps a CBC doesn't matter where you get it, but certainly, cardiac surgery does matter. I don't know how discerning the public is about this. Even the most sophisticated patients don't always understand how healthcare is financed. It seems there will need to be a huge information campaign before patients understand as much about purchasing healthcare as they know about purchasing a car.
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It's not unimportant, but it is overrated as a tool for competition, quality, or most other measures. The more important question is value, much harder to determine for patients and other payers. A good primary care doctor could help patients with this determination of value, but we (FP, IM, maybe Peds) are going the way of the dodo bird.
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if one considers the cpt format or has any clinical (real world) experience with patients, then it is clear that some cases require much more time and energy....the icd does not give much hint what will be needed from the physician .........medicine has been and should remain (un less they are completely nuts) a "t and m" busi ness strictly.......going to a global price would pull the plug on whatever "quality" remains.... it would complete the transition from PROFESSION to commodity.......i see no good in it.....dan
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Educated consumers are better and will help to improve healthcare in the longrun.
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I think a metric to compare services is needed before you set prices
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This issue is way more complicated than 7 questions. For instance Q#5: Do you price shop? Sure you do, I hope. Do you want your patients to price shop? Probably not. When prices are fixed, price shopping is in most cases looking for lower quality to get by. In some cases astute or savvy professionals go for only the profit. Those who care for and empathize with patients during a time of health need forget business princiles and lose. Good luck with the followup survey.
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price comparison would require that prices were for comparable services. As you know, there is no ability to make true comparisons at the present time.
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Price listing of medical services is an anathema. Except for plastic cosmetice surgery all fees are contracted. Telling someone what BC/BS pays for a procedure really is not all that helpful unless they are in the high deductible plans.
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Pricing information without comparable quality information would not improve healthcare. Pricing information alone could do more harm than good.
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We indemnify our own patients, so do not need to provide information about prices to them.
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About time, stressor for health systems to standardize and justify pricing.
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Patients need to know their part of the cost of health care. The costs of elective and unessential services vary greatly and patients have the right to know what they will be paying for. 20% co-pay for services can mount up to a large bill if not anticipated.
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Cost is easy. "Quality" is claimed by all - nobody offers centers of mediocrity - but difficult to show. The battle ground will be price with "extras" or reputation or whatever.
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Focusing on price belies the reality that acute illness is rarely planned, there may be no reasonable alternative to local care, and that trust in your individual physician can't be commoditized. That said, off shore access to large ticket semi-elective surgical procedures may force large and medium sized institutions to focus on simplifying their processes of care. How much of our complex system is driven by legal fears, micro-regulation, and third party inefficiencies, and can realistically be changed, remains to be seen. Price transparency is the latest unproven vogue to restrain the rise in health care costs.
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I beleive healthcare will be viewed with the respect it deserves. Patients feel we hide things from them. We are dealing with a more sophisticated and educated population. Let them be part of the decision and we will receive more of their confidence and subsequently loyalty.
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Quality of care should be the driven force behind a patient searching for a physician and service. Price shopping for health care without focus on quality could result in inferior results.
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This is a dangerous precedent in medicine. Patients will elect to forego preventive care for price. I can see this may even end up in malpractice suits because the patient may later come back and say the risks of foregoing such care were not explained to them. Interesting trend in medicine....
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Employer's are moving here to health insurance with significant co-pays or 'participation' formulas that incent employees to shop. This has greatly increased interest in 'shopping'.
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Health care is perhaps the only industry where the consumer is largely unaware of price and are immune to the actual costs of their health care decisions.
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It will be important for consumers to get price and quality information
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We need to go in this direction. It is clear that educated consumers want this information, and competing on Quality coupled with price transparency will be much more common in the future.
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I do it when I buy a car. Why shouldn't I do it for health care? We have seen people do this for more elective items like lab tests and colonoscopies, less so for acute care needs.
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We do not have a market for self-pay where patients in this category actually pay. Our charges are set at a percentage of current year Medicare rates and fluctuate with the negotiated rates of our payors. We have very little self-pay so that we cannot do anything but set our charges as we do, negotiate agressively with payors, and hope to collect what the payors have agreed to pay.
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Transparency will become more common as patients become more aware of their ability to obtain information by the internet, news media and otherwise.
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Should be addressed as in any other competitive enterprise
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PRice transparency needs to be comprehensive and must include facility charges. Incomplete price transparency is misleading at best.
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Emergency Medicine
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Fully support the concept
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One of the tools to moderate inflationary presure, and a useful tool to introduce the cost of care as an educational opportunity for members and providers-and when providers are members!
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Some of our prices for folks with low income are so low that they would rather pay cash than use or sometimes even sign up for coverage. LL
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1) Absolutely necessary 2)Should be a federal mandate requiring every health care provider, hospital, drug company, medical facility, insurance company, pharmacy to post their prices
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Transparency sounds good, as long as were in a free market, which we are not. If medicine was all cash it would be the best way to lower direct cost to patients.
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The President of the USA asked the the Nation to be tranparent with his executive order dated August 22, 2006. The TRICARE Management Activity the health insurance plan for members of the Uniform Services is following the order. Please go to tricare.mil to view our current tranparency effort which is a work in progress.
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I support all eforts at increasing transparency.
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A fair percentage of our patients are injured workers and therefore we receive payment based on the allowed condition for the claim, office visit, etc.
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Just like Quality measures are showing up on websites like Healthgrades.com, price transparency is only part of the information that is being accessible to patients. Unfortunately, how to interpret this data has not been provided and is up to the person looking at the data to make decisions that are not necessarily truely "informed".
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RE: # 5 - I don't think patients should be able to 'price shop' without balancing 'quality' data as well. You don't necessarily want the lowest bidder doing your CABG!
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You can probably distinguish between very good and very bad. But what do you use to compare and is your monetary unit a dollar per day or a dollar per year saved, or a dollar per complications avoided. How do you value risk?.. and in what risk group are you?... Does it matter if you don't know your risks? ...or how much time have you waited to attempt to resolve your health problem?...or Do you consider a differnt price for patients that smoked, are overweight have untreated or poorly treated chronic condition or a strong family history of cardiac disease, or malignancy?... Does your socio-economic status and understanding of your disease count ?...I think it's very difficult to determine your frame of reference, too many variables, difficult to maintain objectivity..What are you shopping for?...How do you distinguish quality from convenience?...How much is your health worth?...How do you know when you are getting your money's worth?..
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shourld be transparent
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Pricing transparency is part of the wave of reform that is breaking upon healthcare's shore. American's will become increasingly intolerant of our traditional charging/pricing structure, and with good reason. It is illogical, regressive, and at times unethical.
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Transparency is more like translucency. What you see is only a superficial look at pricing. Even for experienced healthcare professionals, the information is difficult to get and interpret through member or consumer channels. And it's virtually without any quality measures. Good marketing; not as simple as it sounds.
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Regarding question #5. A procedure or other service is not like pricing a blender. There are MANY variables to consider. I do not think people can adequately evaluate this.
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Quality needs to be entered into the equation. McDonald's doesn't equal Ritz Carton food service.
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If the public assumes quality, then price comparison will be deadly (literally). Also, in community hospitals, there is price shifting to provide federally and community mandated assistance- the freestanding surgicenters/subspecialty hosptitals (advertised as "cost effective"), of course - will not advertise their lack of community participation.
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Most patients are not interested in the overall price of a procedure but, rather, the cost that is passed on to them after their insurance pays. If they pay a copay the price is less important to them than if they will pay a percentage co-insurance.
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RELATIVELY NEW SUBJECT TO ME..
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True Value Transparency should also include some quality measures and disclosure of volume or experience.
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Price transparency, like quality outcomes and patient safety transparency, will increasingly become an important consumerism demand.
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Our organization has a "cash" price which is lower than the insurance or published rate. This is primarily for those without insurance who are currrently performing most of the inquiries on costs.
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Value equation for patients is critical with shifting responsibility to them for payment. Third party payer system and asymmetry of knowledge has created an uneven paying field for the direct consumers of care and need a more empowered population when it comes to outcomes and cost.
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We are lagging...we know we should do more, but have not yet do so.
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The problem is that any illness does not come with a known price tag. Until the entire system is re-engineered, to make price the only decision point, belies the need to measure quality in a meaningful way. Focussing on price makes the physician practice of medicine a commodity, while physicians are being trained to personalize their service and espouse professionalism over business.
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If people on going to make choices soley based on price, then we will be getting away from other important issues such as quality and service. Once price becomes a focal point, the business is at risk of becoming a commodity, put out to bid to the lowest offer, not the best provider. This will be bad for patients and physicians.
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Transparency is one of the ways to lower the health care costs. The ability to choose providers based on quality is fine but the ability to choose by cost is just as important. My patients currently travel over seas not only for quality but for VALUE.
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none
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critical to the success of patient directed health care. right now, determining cost of medically necessary care nearly impossible for the patient. the confusing reimbursement process of billed/allowed/paid amount, member copay, member coinsurance, & annual deductable (member? family? neither? both? annual? lifetime?) must be simplified & replaced with a market driven price & reimbursement structure that makes economic sense. remastersondo, medical director, coventry health care of nebraska
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I don't see how at this time it helps the patient cosumers. Your "price" is not what your are paid. So unless your rienbusement from all the payers is released it means very little except on the services that are not covered by the patients payer.
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A mixed blessing: on the one hand may help reduce costs and make health care more affordable, which we all want. On the otherhand, there will now need to be another layer of oversight re maintaining quality and attention to monopolies ie the MICROSOFT and WALMART effect.
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Not sure if price alone should be the criteria that we publish and are transparent about. Quality metrics would seem to be needed also.
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the "transparency" lies with reimbursement paid, not charges. The only situation that charges apply in the current third-party payer system is for elective, or non-covered services. For those of us in primary care, with reimbursement levels set by each insurance contract, with each being different, the idea of any "transparency" is obsurd. If we were to be able to collect what we charge, then we would have some control as implied and this truly would be a free market economic reality. I am waiting for someone to explain what how this concept of transparency has anything to do with medicine other than another political spin. When physicians are actually reimbursed what is CHARGED, not some random discount set by an insurance contract, then a free market approach would be effective and welcomed. Let physicians collect their set charges directly from the patient, have the patient collect the amount their respective insurance company feels the service is worth. Leave the phycisian out of the loop and we could lower our charges by 30% instantly due to drop in administrative cost of collecting fees from insurance and waiting 60-90 days for payment. Let the insurance company deal with angry patients who do not understand the nuances of insurance reimbursement and discounted rates. I suggest the free market will dictate which insurance companies will alter their premiums and provide better reimbursement to their customers who are paying the premium. If transparency and free market economics is the goal, then let the relationship be between the consumer and the provider of services. The patieint to the physician for medical services, and the client and insurance company for reimbursement of medical payments as covered by their policy.
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Price is important in a free market, but medicine is now so regulated, that price usually reflects poor staffing, service, or quality. Few providers can give good medical care with the current pricing structure for primary care and primary providers.
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If you are the only game or the other facilities provide such bad care in town then one has no choice and price does not matter. insuranced patients and medicaid patients do not think twice since theri care will be mostly covered. Lowered prices does not mean lowered quality or vice versa.
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If the vKUE nd quality equations were as understood and transparent as the proposed pricing then we would have no objection to total transparency for both..... but they are not and not likely to be for a long while, if ever
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Extremely complex issue. the major barriers to transparency are the artificial pricing advantage hospitals enjoy from the government and insurance companies - which they do not want revealed, and the fact that insurance companies negotiate multiple rates for the same services depending on their leverage with providers in the service area. finally it is usually the physician who is stuck trying to interpret the "transparent" pricing. I really think this is a joke, as hospitals, insurance companies, and the government depend on the lack of transparency to prop up profitablity. Most transparent are physician fees, and they are the ones with the least leverage in the system
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Has not become an issue for regular healthcare in our area. I think it is some for cash services - plastic surgery, LASIK, etc...
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Hospital price transparency thus far is resulting in lower paid hospitals taking tough negotiation tactics to attain the fees of higher paid hospitals.
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Our profession most definitely can use some real leadership! I thought we were not allowed to let other doctors know what we charge?!! At least that used to be the LAW. Given the fact that insurances determine what, if anything, they will give us for our services, besides further depreciating us, how would it help us??? Can a physician in private practice compete with a large practice, or a hospital based practice or clinic?? No. Somebody up there, our "leaders" need to start leading before our profession is completely destroyed. Why don't you have the insurance companies post their reimbursements instead. What does each company pay the physician for a doctor's visit, a hospital visit, and emergency call etc. If the idea of us posting our fees is supposed to cause a competetive price decrease, just think about whether most of us working physicians can further afford to be in practice. Our employees are demanding more money, our patients are demanding more time, our system is demanding that we spend more money on computers and technology. When my furnace broke down, the heating guy charged me $95 just to come out, let alone the cost of fixing the problem. The real question is what are we worth? Where are our values? Why are we (why is the leadership) allowing ourselves(us) to be degraded, debased, demeaned and devalued. I worked hard and sacrificed alot to become a physician, not a provider. Apparantly, I could do everything doctors do by just being a "provider." I am barly making it in solo practice. Is that the way it should be? All the private practices are closing down as docs give up their principles to join bigger groups and become employees to sruvive. Is it right that doctors are becoming employed by hospitals? Isn't it a conflict of interest? Aren't we supposed to be basing our decisions on treatments, etc. on doing what's right for our patients rather than on how to make the biggest profit for the hospitals. And how is it that we have allowed the pharmaceutical reps to have access to what we prescribe??? That should be stopped immediately!! Why would the "leadership" allow the drug companies to have information that they could "use" to manipulate us further??! Somebody bring back some sense of dignity to our profession!--Please!
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As long as we have fee schedules that vary as much as 200% and conracts that state that you must give that company the lowest price you give to anyone else. It will be difficult to offer varing fees or negotiate fees.
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One problem with price comparisons is that patients (and the profession) still do not have reliable means with which to assess quality in terms of potential long term outcomes. ACPE could/should take a leadership role in helping define quality for some of the more common procedures, or service lines. In many service lines there are both problems of too little service provision in addition in other areas of too much service provision.
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A golden opportunity for less than honest organizations to lure patients into their walls on the basis of incomplete and sometimes meaningless prices. Reeks of 'list prices' on new cars that exclude rebates to dealers, and don't list all associated costs. Pure shenanigans.
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Its only natural for patients to start price shopping. However what needs to be addressed is the insurance companies need to be more transparent in the plans they sell. Also physicians and hospital need to be able to negotiate with the insurance companies in groups . This is especially true in areas where there are only 2-3 main insurance companies. R Delorme.
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I agree with the concept. If we intend to continue with our current health care system funding mechanisms, then using market forces, such as price transparency, to create competition among payers should drive prices lower.
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Since cost is price times volume and volume is indeterminate to patients "transparency" is clear as mud.
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I work in free fee for service
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Transparency should be for Episode of treatment costs and not just individual CPT or E&M costs. It is easy to increase total cost of an episode of tx even if a single code is priced very low.
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It's ok for in-store mini-urgent cares, but not for physician services.
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the end result is the commodity, providers are assumed equal,where is perception of quality in this model?
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My organization has however made policies regarding self pay. Specifically, certain radiologic procedures ie CT scans are now a reduced flat fee for the self pay and there is also a self pay discount for other charges.
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since prices are artificially inflated to encompass all payers including those who pay %of charges, actual price becomes irrelevant because nobody pays actual charges except the unfortunate person with money but without insurance. we shoucl be able to steeply discount charges to that person but cannot because of CMS prohibitions regarding having more than one fee structure.
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I'm a plastic surgeon and have had set prices for my cosmetic procedures all my practice life (25yrs). This includes the hospital fee which I negotiate myself. It has required the hospital OR OD's to evaluate their procedures and prices. It is possible to set prices for care, it's just not commonly done and is uncomfortable to do at first. It certainly makes you more aware of what you do and how much it costs. If it impacts your bottom line you pay closer attention! Competition is healthy. It's the American way!
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This subject has not really hit our area. Our prices are all controlled by either the government or MCOs. To discount the patient responsibility portion of their MCO charge is illegal.
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price does not correlate with quality. If we start getting into low price wars the patients will ultimately suffer as many will choose based ONLY on price.
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The fundamental issue is VALUE, not price. VALUE is directly proportional to QUALITY and inversely proportional to PRICE. Therefore, providing information regarding PRICE is rather meaningless in the absence of accompanying information regarding QUALITY. All those who have studied the issue have concluded that, in the long run, the highest QUALITY (especially in Healhcare) costs the least. Therefore, focusing upon improving QUALITY lowers cost/price and increases VALUE. So, let's get our acts together and improve QUALITY throughout the healthcare system. Allan B. Kortz, MD, MHS
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This may very well result in some selections being made for price that sacrifice quality care.
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price transparency has merit cost transparency should also be available healthcare, being a noneconemic good, does not fully fit the "shop around Model" cost, price and quality transparency should all be in the same senrence
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We are happy to share price info with patients if they ask but at this time do not feel a need to post prices. Obviously this could change.
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Price transparency should depend as much on the insurance companies as on the providers.
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All patients in our practice are commercially insured and are therefore, price insensitive. The carriers are very cost sensitive and have negotiated among the lowest rates of reimbursement in the nation (San Francisco Bay area). Pricing at the provider level is irrelevant except that patients are appalled by the prices of hospital and hospital-based services that are several-fold the CMS-allowed amounts, even though they do not pay such prices. The only people who are pursued for payment in full for these exorbitant prices are those who are uninsured, the least able to pay. The inequity of pursuit of payment in full when the hospital and hospital-based services routinely so deeply discount their services to carriers is a bitter issue for the entire public here. The legal reasons for the pursuit of payment in full require redress immediately. At a meeting on hospice at UC San Diego, I believe that we were told that 40% of families with a terminally but chronically ill member declare bankruptcy. This statistic, regardless of its accuracy, is the source of a lot of public dissatisfaction with healthcare pricing. The injustice of this single issue taints all healthcare pricing and, I fear, will throw the baby out with the bathwater as legislative efforts are made to redress it. Additionally, employers and the governments may confuse the issue of pricing transparency and equity with further efforts to contain cost via some pricing model. At the physician provider level, most PCP price between 100% and 165% of CMS allowable, medical subspecialists between 200% and 250%, but surgical, radiology, and anesthesia specialists price between 250% and 400% CMS allowed amounts, of which patients are aware when they see the EOB after payment by their carrier or if they have a co-insurance payment based upon percent of claimed charges. Meanwhile, these same patients are reading public press accounts of all-cash services in Thailand, India, China and Mexico, at a fraction of US CHARGES. These commercial and government payer irrelevant charges are creating and reinforcing a multi-facetedly negative image of healthcare providers and their value proposition with the public at large. Increasingly, the URBAN physician provider network in our CA community is becoming fractionated and factionated. Increasing numbers of physicians are going to a non-par, all cash, no insurance benefit assignment accepted model in which the patient receives the allowed amount after paying cash at the time of service, usually 100-125% of CMS allowed amounts. Some are going to a concierge model, in addition. Some pediatricians are refusing to provide immunizations other than all cash at the time of service. All of these "non-par" provider initiatives are to some degree local provider responses to perceived "fairness," just as the consumer market is seeking "fairness" via pricing transparency which the consumer, in part, hopes will unleash free market competition among providers. At another level, pricing transparency among providers, consumers, and competing providers addresses another issue of "fairness," by leveling the playing field with respect to the availability of pricing information. Currently, only the payers have this information in their claims databases but providers are statutorily prohibited from discussing pricing, which subsumes price. The second physician provider group continues to provide discounted fee for service or capitated care via commercial carriers through the IPA model, but it is from the ranks of these traditional providers that the first group is coming and upon which hospital-based systems are poaching with Foundation-based physician recruitment. In CA, the issue of hospital system ownership and employment of its medical staff is emerging as a critical challenge to the balance of power and ethics at the hospital level and a challenge to payer contract negotiations when the regionally consolidated hospital system controls the provider base as well. Federal, state and county providers also fall into this model. In essence, there is an impetus towards Kaiser and Kaiser form fruste. This impetus is accelerated by current med school student recruitment profiles and the recalcitrant lack of business education in medical school and residency. Furthermore, there is no spirited industry or public scrutiny about the multi-order effects of these policies as they affect industry and service ethics, delivery or organization. Finally, there are traditional medicaid providers who are now largely capitated managed care PCP's and hospital-based specialists who are paid indirectly through the hospital for their availability and/or services. Bottom-line: Within CA, the differences regarding philosophies of care delivery (even ethics), medical practices, provider-patient relationships, service delivery processes, and value chains among entrepreneurial and employed physician providers is becoming both more polarized from each other and more perverted from alignment with the welfare and incentives of the patient, community and ultimate payer. In the US, we use money/price and righteousness as metaphors in these discussions, regardless of industry. Consequently, I think that pricing transparency is merely a metaphor for larger issues. It may be an early stage tool in a free-market process of addressing those underlying "fairness" issues that have resulted in the multi-level market demand for transparency.
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I believe Physicians who do gastroenterology and especially endoscopy, are being driven out of Privately (self)owned endoscopy centers. Costs of operations are increasing, and reimbursements are decreasing. Options include working alone, using suitcase computer for billing and dictation anad record keeping, encountering patients in the hospital, and doing the procedures in the hospital. This decreases overhead to the nub, and allows the MD more time for a decent life.
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Having unrealistic "sticker" prices (eg charges) that virtually no one pays and which rise much faster than even medical inflation is pointless, creates patient anxiety and gives healthcare providers with a perception of price gouging which we do not need. $5 aspirin needs to go away.
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Unless larger issues with controlling health care costs are addressed, employers will have to push costs to their employees in order to stay competitive. Given the trend for technology to penetrate Healthcare IT, I think the trend for price shopping, and quite soon on line price shopping for medical care will expand.
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Overall a good idea
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I work for a Hospital that serves indigent patients. The majority are covered by Medicaid or Medicare and this population does not care about Hospital charges since they don't pay anyway!
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Price may be important if the patient actually has to pay. I do not have a feel for price differences between organizations, and since Medicare and other payors pay what they pay, most of the time your "price" doesn't necessarily mean that much.
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It is coming. Problem is customer understanding of pricing in healthcare.
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Showing prices without related quality is disingenuous and probably immoral.
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I also think quality data should be transarent, as well.
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price transparency is a good thing, price competition is even better
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In our state (Maryland) prices are essentially regulated for all health care except cosmetic procedures, so price competition is generally not an issue. Speaking more generally, the patient who relies on price as a major determinant in making health care decisions is taking a very narrow view of a very complex issue.
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I am currently without healthcare insurance, and often compare prices as all healthcare expenses are paid with my money, not the insurance company's. Here in California, many hospitals and physicians have generous discounts for "cash up front" (40-50% off).
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I believe they are a good idea-- if patients can be made to understand value as being more than a low price (as in all others forms of economic endeavor in the US)-- then this discussion means something.
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I am hoping that, in addition to cost shopping, that patients are looking at results of diagnosis and treatment (i.e., the "whole package". WalMart medicine, is not always the best medicine for every patient and every disease.
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Medicaid & Medicare represent 95% of our organization's revenue streams.
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Too many hidden payments to hospitals and money extracted by "insurance companies" with no worthwhile end product. Instead, we see many new palatial clinics, hospitals and "insurance company" buildings with no improvement in medical care.
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Haggling over prices and shopping around for the "best deal" is not appropriate in Medical care and only serves to further foster the dangerous misapprehension that Healthcare is a business/service to be purchased from the lowest bidder regardless of quality of care provided.
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It is coming just not sure the best way to present data to patient
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patients are not generally sophisticated enough to make healthcare decisions strictly on the basis of price and not factoring in quality and safety.
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easier said than done
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I don't get paid for the prices I charge now; insurance companies set "prices"
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My company, CIGNA healthcare, has made a high priority of consumerism and empowerment of the patient. We are trying to give the insured the motivation and tools to make cost-effective decisions regarding their healthcare.
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you get what you pay for. If someone buys a cheap radio at Walmart and it breaks, so what. If someone goes to an inexpensive cath doctor and suffers an avoidable complication like a stroke, so what. Oh, I mean it's only their brain...or life.
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It's a good idea. I work in a practice that is almost entirely paid by a third party (Workers Compensation), so it is not much of an issue to patient. It is an issue with the insurance companies.
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Charges are not prices because of the multiple payers and allowable rates. Even consumers with HSAs receive the discounts associated with their health plan. This makes transparency very difficult to accomplish.
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This is going to put a premium on the one area where there has the potential for there to be meaningful, comparative data: quality
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our hospital now posts "5 pillar results" on bulletin boards all over the hospital. i dont think prices are on it though.
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Price Transparency is only helpful when the market price is known. The fragmentation of services by CPT into an "al a Carte" menu means that price transparency is not much of a behavior shaper. When two gas stations across the street from each other post their prices, that is competition. When two physicians do it, it is collusion. Without fixing the FTC and DOJ attitude toward mutual price disclosure by physicians the "price transparency" issue is dead in the water.
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Most patients will pay a somewhat higher price if they perceive quality is better. This is a better alternative to the "Pay for Performance" initiave by third party payors.
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It is equally important to have transparency of payments made by third party payers.This information must be made public as there are significant differences in payments made by the same payer for the same procedure/DRG to different providers/hospitals,for no apparent reason!
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As an emergency physician, I'm always acutely aware of EMTALA/COBRA regulations. I'm concerned that posting prices may represent a barrier to patients getting care. It seems logical that some sick but poor patients will remove themselves from the ED if they find out the bill will be over $1000. What is our responsibility as it relates to EMTALA/COBRA with this issue?
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Perhaps price shopping can be a tool to get rid of some of the tremendous waste in the system. Much of what we build into the charge has minimal proven value to the outcomes.
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Just as with most items in a capitalist society, cheaper is frequently not better.
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Patients are like sheep, they go where you head them.
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In theory, price transparency is great. But it requires knowing what precisely you are buying, which is impossible in health care for most laypersons. If you want to buy "a car", the price can vary by over 1000%, and as consumers we understand and accept that - a Ferrari isn't a Kia. But even experts can't agree how to measure "quality" in healthcare, so how can non-emergency patients really calculate value recieved for money spent? When we have a Consumer Reports giving trusted ratings on hospitals and doctors, then price transparency will have meaning.
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Patients and doctors have to work pretty hard to find out hospital prices. Well kept secret. Inflated rates hurt only the uninsured and protect the insured. System is crazy.
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I'm somewhat scared about price wars in medicine. The potential for reduced quality of care exists as practices look for ways to reduce internal costs in order to be able to lower charges.
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All superficially comparable services are not necessarily equal -- making true price transparency / comparability a challenge, with potential for the cart getting ahead of the horse on publish first, retract and clean up later.
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It a pity that docs should argue about prices with patient more than actually treat ones.
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Price transparency without risk-adjusted and outcomes data is meaningless. While there are antitrust concerns about disclosing pricing, the principal issue is that there is a discrepancy between healthcare and other sectors-due to the third-party payment model. At my AHC, the out-of-pocket costs for a outpatient visit for a government insured patient is $11. The co-pay for the visit is $3 and valet parking is $8. So much for pricing!!
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It is really important to understand what your real costs are, because without knowing that, you can easily underprice your services and lose money on every "widget" but "make it up on volume" - we all know that doesn't work!
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We physicians in the DFW area have been hit incredibly hard by the hospitals and the health plans. The pricing transparency that needs to occur is at the level of the institutions.
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will be necessary as HSA's or high deductible insurance becomes more the norm. Our choices will be between the above or federally subsidized insurance probably with a variable deductible level depending upon household income
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Transparency is happening in all sectors of the economy; there is no reason health care should be different.
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since price does not take into account quality and relationships of physicians with health plans and hospitals price info is not always accurate or appropriate. A lower priced physician is really higher priced if not an "in plan" physician
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Its about time!
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Quality needs to be the driving decision for a patient, perhaps combined with some aspects of price, but healthcare is not the place to expect Walmart competitive pricing...
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You get what you pay for.Quality will suffer if competitive pricing pressures are too effective
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Transparency is a growing manifestation of consumerism in medicine. It is being fueled by the mistakened, unproven assumption that price-sensitive health care shoppers will spend their health care dollars more wisely which in turn will reduce overall health care expenditures. Right or wrong, the expectation for increasing transparency is here to stay, and we will need to adjust to it.
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Dangerous to equate "quality", "price" and "outcome". Need much much more data.
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Health care is far beyond such simplistic comparisons ... an empty 'buzz concept' dreamed up by CEOs who, themselves, do not understand the product they 'sell'.
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I understand the need to price shop. My concern is that this will further erode a very narrow bottom line.
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prices only useful if services directly comparable, and quality also comparable...doubt will ever catch on...too complicated
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Most prices are set by Medicare and the insurance companies. It really doesn't matter what price you put out there, because the insruance companies pay what they want to pay. Price transparency is really only good for those who have to pay out-of-pocket, of which we have very few patients doing this.
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You'll get what you pay for, UNLESS price transparency is linked to quality outcomes for severity-indexed cohorts- and that isn't yet on the near horizon in my part of the country.
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Multiple payors with multiple plans create logistical problems for doing this. The posting of charges will not give patients useful information unless they are paying "cash."
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This has been long in "the making" and physicians have "no one to blame" but themselves. While the above words sound harsh we have not developed leadership with understanding in business, finances, marketing, public relationship and more. We have "assumed" that the public will continue supporting us while the quality of healthcare deteriorated (See the IOM report: To err Is Human), the service has been failing (waiting time in the ED for example), the answering machines taking place of PEOPLE, all these and more have turned us into a commodity, like coffee. It is not too late to change; alas the direction at which we are going will not get us there. As Yoggi bera said: "If you do not know where you are going you will not get there..."
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As long as patients are protected from price by their insurance carrier [Medicare] I doubt price transparency will have much effect. Patients go where their doctors and insurance carriers send them.
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My persoal feeling on price transparency in health care is that it is a good thing. However, it must be monitored for Quality Assurance purposes.
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However we have no insurance contracts. We are out of network for all plans. Freedom at last!!!!!!!!!!!!!!!
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Of course, increase in CDHP's will drive the need for data in the hands of consumers, on both price, volume, and outcomes/ quality. Patient satisfaction ratings will be big. Price issues will be a touchy subject for all sides, as providers will also glimpse how they are paid compaired to other providers.
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our thought is being first to do this in our market may be an advantage, as soon as the others do it, there will be little market benefit
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As the Center for Medicare and Medicaid Services reimburses for pay for performance measures, and enhances payment for providing data on certain outcomes - then publishes that data for beneficiaries to compare performance (for now only for hospitals) - the demand for more data by health consumers will increase. Price and cost data across delivery systems, and data democritization might help individuals be more sophisticated health consumers - but the current measures are crude, and focus on a small number of issues.
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We've published several articles on tis topic & would be willing to offer a workshop or course on the opportunities and challenges presented by transparency in healthcare.
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Only useful if it also contains quality information. No one wants to see a bad physician, regardless of how cheap they are.
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Until there is info on what different issurers actually pay versus what the charges are, there will never be transparency. Recently, several hospitals in our area announced that selp pay patients will now be charged the average of what the top five insurers pay for a given service. This number is what would make a differnce but is obviously not one hospitals will want to post on their websites.
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Price is important for the entire system; price does not equate with quality so that the value of a given service by a given provider remains elusive; not sure patients understand this.
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Prices are irrelevant because the health care system is about contracts and deals. "Price transparency" is another way for the payers to reduce reimbursement by forcing providers to cut costs even if margins are minimal. It makes the providers the villains because they had to cost-shift to get reimbursed for all the unfunded mandates. If providers like hospitals could bill for the reality of how they operate, things that they are told are required to provide safe, equitable, high-quality care, patients would see a charge for Joint Commission compliance costs, CMS chart abstracting costs for National Hospital Quality Measures, costs for disaster preparedness, and costs for all sorts of similar things. The aspirin would go back to being $0.10 rahter than $10, but there'd be a $200 charge for the amortized cost of managing a nursing competency assessment program, another $50 for that patient's share of having a medical library and $12.5 for their share of patching all the firewall penetrations. Then patients would really see what it costs to provide health care, and we could focus debate on what is really worth it and what is not.
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Most listing of prices, as they exist today, are nearly meaningless to patients. They are rather interested in what the cost will be to them, based on their health plan. Transparency of cost and pricing must be at the individual level if it is going to affect choices and behaviors. This is not a market where folks are paying list prices...so why list them in that version
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We are way behind the eight ball in healthcare around this issue. Partly it is because there are so many contracted rates that differ so hospitals often don't know the real price. We are trying to standardize the chargemaster but it is slow go. We cannot give the full price of a surgical procedure because the surgeons and anesthesiologist have their own charges. We should be able to give accurate pricing for labs and xrays but we are not doing even that. I am surprised that patients have stood for it this long and the time has come for us to be transparent about the cost of care.
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Very much needed in combination with quality transparency if market forces are to be used to control costs and improve quality (see Porter/Teisberg)
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As more patients become Internet educated about their illnesses, it logically follows that they would seek that treatment at the lowest cost
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It's like the use of information technology in healthcare...long overdue
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Price information in the absence of other important information, e.g., quality measures, is misleading and may cause patients not to receive the combination of services they desire.
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The pricing system is harder to understand than that of the airline industry. The providers frequently can't understand or explain it. It is difficult to understand how patients will figure this out. How do you post prices without knowing the details of their health plan. No one pays the published price anyway (except the naive and uninsured).
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People will also travel to other countries!
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Patients who are paying out of pocket should price shop.
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All purchasers should be able to gauge the value of their goods, especially in health care. However, I'm not convinced that any site that I have visited provides enough information to make sound decisions because of the complexity of services and the complexity of the development of the price, itself.
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Generally a good concept.
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Let the free markets rule.
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Shopping for healthcare based on cost may provide cheaper services but not necessarily quality service. We are not the automotive industry or other competetive bussiness and should not present ourselves in that light. A better option would be a socialized medica system similar to that in the UK.
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Health care is not a commodity. Patients that make medical decisions by comparison shopping are playing a dangerous game with their lives. The market will respond to the economic forces and quality may suffer. I certainly would would feel uncomfortable knowing a patient came to my practice solely on the basis of how much I charge - it's much more comforting to have a patient rely on you for care based on your medical and surgical skills.
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When patients shop around, they need to know that the cheap MRI might not be good enough for your surgeon to make a clinical decision and that the more expensive MRI is a newer machine with improved abilities. Transparency can't just include price; you need some quality component to it too.
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Price transparency could only make sense if we have a free healthcare market. Healthcare is badly controlled as it is and quality is threatened with the drop of reimbursement rate & profit margin. The demand for technology and more paper work is higher driving the overhead up steady. The system is stalling and hanging in more gears. The percentage of government insured patients is increasing to the point that the losses in taking care of the government paid patients are not offset by the profit margin made on the commercial insurance. So, Price transparency might be an intriguing concept but it does not applicable and not practical. We are the only business that goes out looking for trouble for itself. I believe there is a gap between academic medicine that is mainly setting the roles and private practice that has to live with these roles. Some how people in academic need to feel how it is like to run a business and what it takes to run it well. May be the solution is: 1. less taxation 2. more money with the people 3. more small business 4. less government programs e.g. combine medicaid and medicare in one program for low income patients at any age 5. free the healthcare market and let the customer choose When we do all this, price transparency would make sense
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When we look at pharmacy and health insurance companies and their 'mark-up; then we should be looking at practitioner's prices if we truly want to control healthcare costs.
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just as everywhere else, the consumer/client has full right to know the price for services and be able to price compare. However; the quality of services should also be made transparent so that price vs quality can be compared and considered decisions made by the consumer
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Tricare operates a public web page for looking up the maximum allowable charges for outpatient procedures, but I do not believe the general public uses it, just medical professionals.
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when pateints begin to pay for their own services, they will price shop, similar to what they do for cash services such as cosmetic procedures. As long as healthplans are the intemediaries that pay for services, there is not a direct connection between supply and demand and there is no reason "shoppers" will have an advantage by price shopping.
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many of our prices are set via governmental fee schedules, e.g Medicaid. Some states post the schedules but they can be very difficult to access.
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The price, cost, value situation in healthcare is crazy. At present the price disclosure is very questionably helpful to patients with out much explanation. The connection between cost and price is tenuous at our practic and needs to be tightened to have price transparency mean anything to our patients.
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Transparency can exist only when all payers, including Medicare and HMOs, agree to pay standard rates. As long as certain payers demand discounts based on market power, transparency cannot exist.
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Pretty much meaningless in our present "system." Self-pay patients cannot afford any care and other prices are controlled by payors. Charges have little or nothing to do with what patients pay.
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Overall not a good idea. Prices are established by Medicare and other 3rd Party Payors and participating physicians cannot alter those prices. It is OK for such services as Flu shots, copies of Medical Records, tailored leters for specific requests.Physicians who do not accept insurances should provide specific charges before rendering care, these would include emergency nservices as well.
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I am at a children's hospital with no other comprehensive pediatric services for more than 300 miles away. If children's families price shopped , they would get a very inferior product which often ends up coming to us anyway. That frequently ends up in higher cost. Thus, in my spectrum of healthcare, price shopping would be a disservice to patients.
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I find that true healthcare price shopping and comparisons will be just an illusion and not based on reality as lons as the payors continue dictating where their beneficiaries can go for healthcare, such as in network and penalty for out-of plan costs at 20% or greater? What real choice do the customes have with our 3 rd party pay system??
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These are the wrong questions for most of the primary care deivered in America---There is no competition and prices are not set by physicians but by payers.
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Need quality data for rational comparisons
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prize transparency, as well as, rates of complications / outcome should be part of better business, work ethics and excellence of care
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Patients and families should be provided information how to manage their health, navigate the health system, and negotiate health costs. This should be provided in ways that are culturally-sensitive, health literacy and language appropriate. There should be a person to act as an information intermediary between the requester of the information and the source.
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Although I think it is a good thing, I don't think patients should be price shopping for health care. True, our prices should be published but I feel prices should be the same for any given region. A CAT scan doesn't cost any more at my institution as it does in another. Prices can vary greatly. Price transparency will keep governmental agencies from fixing our prices like they're done to do DRG.
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Other goods and services are not subject to price control. 65-70% of our patients have government funded care that sets prices. The remainder of patients are subject to out of pocket expenditures that is not correlated with pricing policies of institutions. Furthermore, our cost accounting system does not afford us the capability of pricing a la carte services.
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Price and Quality should be completely transparent
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It will likely drive down the cost of health care.
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transparency is mnore important in the outcomes and quality world. pricing/reimbursement is primarily driven by Medicare and commerical(managed care) payors and has little bearing on real costs.
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Makes sense that patients can shop for the same quality tests/scans/treatments at the best cost. Most patients currently spend more time shopping for a TV set or a major appliance purchase than they do comparing costs of major tests/procedures.
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We've always been open on prices similarly to any professional group. If you walk into an attorney's office, you don't see a price menu on the wall, but you can obtain their hourly rates upon request. For our physicians, we're in the same place. Rates are available upon request but posting them would put us on the same plane as a Good Year tire center.
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Patients have multiple eligibility (private insurance, VA, DoD, Medicare, Medicaid, etc) for health care and may choose what payor gives the most service for a particular need. They already shop around for services.
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Insurance companies have already determined what we are reimbursed so what we charge has no value anyway. The consumer may think he is getting a deal by shopping around (charged amount) with the same actual reimbursement realized by all physicians in that area. Quality should be what we sell and I suspect that if price lowering happens so shall time spent and quality of care. Right now we are juggling to keep offices open and patients seen with current reimbursements. The only way it can work is to no longer work within the constraints of insurance reimbursements, bid to the consumer and let them file their own claims and get reimbursed for their out of pocket expenses themselves.
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I am employed by the hospital as part of a hospitalist group, and I just don't know the answeres to these, sorry.
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"shopping around" implies that services are identical and that only price is different. But that is not the situation in health care. We couold end up with hospitals seeing who can give the least service for 5 bucks less.
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SInce utilizing what is charged instead of what is paid makes the transparency issue not transparent. X hospital charges Y$ for a procedure and A Hospital charges B$ which is posted but both get the same C$ What is differnt about the hospitals charges
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Price transparency is important. Our patients want it, and they want a good service at a reasonable cost. By setting prices and showing them to patients help them to get over the costs and allows us to set a reasonable cost for our services. This is a good thing.
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When people know the prices, they should be able to be better engaged in the decision-making process regarding their healthcare.
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