How Taking a Page from Amazon will Help Consumers get a Breakdown of Healthcare Costs

Online or brick-and-mortar retail is all about making the purchase easy. Whether it’s a price comparison tool or an email reminder that an item has been left in virtual shopping cart waiting to be bought, online retailers do all they can to ensure the sale goes through. The same experience can be had at your local grocery store: the item on the shelf is clearly marked with a price. High-tech or low, you know exactly how much it’s going to cost.

Everyone who goes to a doctor wants healthcare cost transparency. It’s that simple. And also that complicated.

A recent article published by Medscape describes the simple retail process: “In business transactions outside of healthcare, consumers choose what they want to buy, do some research or consult someone to help with their choice, determine the cost in advance and whether they can afford it, and then pay for the item. Before the purchase, buyer and seller both know the cost.”

Getting a breakdown of healthcare costs is a rarity when seeing a doctor.

But What if Your Doctor did the Same?

Providers need to take a page from online retailers and make it easy for healthcare consumers to understand why treatment costs are what they are. The good thing is that many providers to want to offer the information to patients: 85% of providers are looking for ways to automate treatment cost estimation, according to Black Book research, there’s still a long way to go before a standardized tool is rolled out for all providers.

When entering and leaving a physician’s office today, healthcare consumers know they have a co-pay, but beyond that, not much else often is known. If the healthcare consumer gets tests or other services they may not how much it may cost or even be aware there will be a separate charge for procedures.

Now for the healthcare version from that same Medscape article: “(T)he clinician typically chooses the purchase by ordering tests, medications, and procedures but may have no knowledge of the costs or any obligation to pay for those choices. The consumer presumes that the choices are wise and necessary purchases based on the role of and his or her relationship with the clinician. Insurers have formulas for determining what they will pay for and how much, but these are not usually clear to the consumer. Moreover, the final cost and payment determinations are made after the transaction has been completed and a bill has been submitted.”

While this explanation is accurate, it’s also complicated. Suffice it to say the healthcare price model is akin to buying a can of tomato soup, taking it home, eating it and finding out, and being surprised by, how much it costs weeks later.

Additional Cost Concerns

With the yearly increases in deductibles and premiums, health insurance continues to chip away at the income of healthcare consumers, so the last thing any of us want is an unexpected bill following treatment. The ability to offer a full accounting of the treatment cost prior to leaving the doctor’s office is where the healthcare industry needs to be.

The capability to provide this information to healthcare consumers lies in the ability to access the right tools for the job. These tools have the ability to run cost queries and provide an estimate of treatment costs at the time of service, allowing healthcare consumers a better understanding of additional payments they may have to make later on. When office staff takes the time to explain the charges to the healthcare consumer, this helps to lessen the future impact. In addition, offering this service almost entirely eliminates the chance the patient will receive an unanticipated bill.

With the right data and technology in place, a future visit to a healthcare provider may seem, from a billing standpoint, more like the local supermarket. Which would be a positive development for healthcare in general and support healthcare consumers who want to know more about their care and understand why things cost what they do.
 
Blog Comments

Comments
Blog post currently doesn't have any comments.
Subscribe
 Security code

TriZetto Provider Solutions® Powered by Cognizant

We help physicians, hospitals and health systems simplify business processes and get accurate payments quickly. We will always look for new ways to help you improve revenue and increase cash flow. We will stay ahead of regulatory changes so your office will never struggle to keep up. All so you can focus on the one thing that really matters: doing what is best for your patients.

Learn More