A patient looking for a good price for a basal cell carcinoma removal posted to his blog his needs and asked for providers to bid for his business. He received none, as “hospitals don’t have a ‘submit a bid’ department. Calling around asking prices, he found that neither hospitals nor insurance companies knew what the price would be. He finally selected a surgeon, and today he is fine.
There is too often no way for patients to discover good prices. A patient takes doctor’s orders and hopes that the bill will be reasonable, having no information about quality or price – which is found out afterward. However, most of health care is non-emergency, therefore being “shoppable”.
One reason that patients now want to shop around is the increase in high-deductible insurance plans. New data is available in the form of online physician and facility rating. Two commonly used websites, Healthgrades and RateMDs, provide reviews and basic information about physicians. CMS and Leapfrog rate hospitals on dozens of criteria.
All patient experiences will be different, depending on the procedure or physician. Procedures with the same doctor will differ in prices between a surgery center and a hospital. Even within a facility costs may differ.
Transparency is the foundation for everything. Insurers are beginning to publish negotiated prices. Even with prices being published, insured patients still are not shopping around – but they will with a high deductible. How do patients look for low-cost health care?
Reference pricing is a new strategy for employers. Their insurer sets a reimbursement limit, a price near the median for a procedure. The employee can go to any physician or facility for their procedure, and any amount over the limit is paid out of pocket. Patients are shifting to surgery centers and lower-cost hospitals, forcing high-cost facilities to drop their prices. This strategy may become a regular option in the standard health plan design.
Another way to control cost is to reward patients for selecting lower priced care. SmartShopper, a program which works with employers, gets a list of providers and facilities ranked by price. The patient gets a rebate after they pay for a procedure, in proportion to the cost. Patients don’t have to switch doctors, just facilities. SmartShopper takes 15 to 20% of the savings.
MediBid uses competition and price transparency to bring patients hundreds to thousands in savings. We work with employers and individuals alike. All MediBid physicians are verified to be in good standing, and patients can check out physician profiles before selecting a bid on their requested procedure.
Rosenberg, Tina. “Shopping for Health Care: A Fledgling Craft.” Opinionator. The New York Times, 12 Apr 2016. Web. 14 Apr 2016.