You know exactly which store or brand to go to when you’re looking for a new smartphone or laptop. And if you’re not sure, you know where to find price comparisons to ensure that you’re getting the best value for your money.
Have you ever done the same for your medical expenses? Have you ever looked up the price range for a particular treatment? Do you know where you would even find the best deal for surgery, a test, or a simple consultation? The majority of the answers to these questions is probably “No.”
And this lack of transparency is one of the primary reasons we end up spending so much money on healthcare. Lack of price transparency can lead to significant cost fluctuations as well as the absence of real connections between the quality of the services you pay for and their value.
Can bundled payments be a solution to ensure price transparency?
Let’s look at the big picture before we give a definite answer.
Price Transparency Issues in Healthcare
If you’re like most Americans, you’re probably not sure about the cost of a trip to the emergency room until you get your receipt in the mail from either the healthcare provider or your health insurance company. Most people like to know the value of things before buying them so that they can plan their budget accordingly. But, when it comes to medical services, providers lack the discipline of sharing price information with their patients.
Of course, evaluating the costs of surgery could never compare to estimating the costs of replacing or fixing an electric appliance. Approximating healthcare costs is a complex subject. It is tough to predict how long a treatment will last, what it entails, and if it will need work afterward. However, price still plays an important role in treatment, as much as anyone would like to say otherwise.
The quality of services is another aspect that is more often than not completely ignored and left out of the picture. Learning about the quality of the services you receive is crucial, and no decision should be made without it. Still, no rule connects price to quality, and services that are more expensive do not necessarily mean a better quality of care. The same goes for drugs or treatments. The price isn’t a guarantee of quality, so switching for more expensive ones will not guarantee it will work better or faster.
Good quality healthcare means that the doctors as well as the rest of the staff treat you with respect, listen carefully, and take the time to explain everything so that you understand what the treatment entails. Moreover, good quality healthcare means that in the case of emergencies, doctors and specialists tend to your needs promptly.
Price transparency should include basic information about the services you are about to receive, such as:
- The Total Price of the Services: the patient should be aware of an estimation of the total cost of the services they will perform.
- The Network Status: The provider should disclose whether or not they belong to the health care network of the patient.
- The Costs Supported by the Patient: After consulting the patient’s health plan, the provider should be able to estimate the costs that are included in the plan’s benefits and the rest of the expenses they will need to pay for by themselves, separately.
- Other Important Information: Any other relevant information related either to the services the patient will pay for and the provider or facility should be disclosed to make sure the patient is informed about every aspect.
Why Patients Are Choosing Hospitals Over Private Practices
Unfortunately, there are numerous instances where patients undergo treatments or surgeries in hospitals covered by their insurance. Then after the treatment, they discover that they need to pay extra costs for out-of-network specialists, despite having had these specialists attend to them in that particular hospital. What’s frustrating about this situation is that people still continue to pay massive amounts of money on healthcare, when in reality, considering the trend of doctors transitioning from private practices to hospitals, the situation should be opposite.
How much should we pay for healthcare and how can we improve patient value? Reimbursements through bundled payments present themselves as an effective way of lowering costs and providing accountability of the services offered to patients.
Access HealthNet has made it its goal to promote a transparent market, offering services for both providers as well as employers and can help them take control over their healthcare costs. Access HealthNet also offers the tools and the flexibility to link patients to the best, most appropriate health plans for their needs.