Consumers Need Pricing Transparency Now

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Last year, Robert Wood Foundation, whose mission is to improve the health and healthcare of all Americans, published an issue brief, “How Price Transparency Can Control the Cost of Health Care,” and noted that “price transparency does not only serve an educational purpose – it actually lowers the cost of health care.”[1] Health Affairs quoted the foundation as saying: “Health economists and other experts are convinced that significant cost containment cannot occur without widespread and sustained transparency in provider prices.”[2]

Half of Americans have tried to find pricing information before obtaining healthcare, according to a study just published by Public Agenda.[3] And 63% of respondents say there is not enough healthcare price information available. This groundbreaking report summarizes findings from a survey of 2,062 U.S. adults, ages 18 and older, from the states of Texas, New York, Florida and New Hampshire. Survey participants are considered nationally representative. Robert Wood Johnson Foundation and the New York State Health Foundation provided support for the project.

Findings were interesting and in some ways presented dichotomous viewpoints, especially regarding respondents’ opinions of insurance companies. To take advantage of all of Public Agenda’s findings we recommend reading the research brief in its entirety.[4] However, of the many statistics contained in the report, we are sharing the following because together they reveal important Implications for providers, insurance companies and state governments:[5]

Providers

  • 77% of Americans trust their doctors a great deal.
  • 70% of Americans think it’s a good idea for doctors to and their staffs to discuss prices with patients before ordering or doing tests or procedures or referring them to specialists – yet – only 28% say a doctor or staff member has brought up price in conversation with them.

Provider takeaway: Consumers trust you. They yearn for that “hard conversation” about price because they are responsible for paying a high portion of that cost. Consider implementing ways to share pricing with consumers and be sure your staff is trained on how to have those conversations.

State Governments

  • 80% think it’s important for their state governments to provide comparative price information
  • Yet few people have heard of their states’ price information websites

State Government takeaway: Americans are trusting you to help them find healthcare pricing information. If you don’t have a website that provides this information, it would be in your, and your citizens’ best interests to create one. If you already have such a site, people don’t know about it. States need sites and they need to publicize its existence to their residents.

Insurance Companies

  • 68% of respondents think insurance companies are mostly interested in making money – yet – many of the responses indicated that when looking for healthcare pricing information, Americans turn to friends, relatives, colleagues, insurance companies, doctors and receptionists
  • And, 46% of them said if they were to look for pricing information they would call their insurance company or look on its website

Insurance company takeaway: Many people think you are interested in making money. Yet they turn to you when they need pricing information. Providing healthcare prices to your membership gives you an opportunity to help your members as well as improve your image by educating your members that you are providing pricing to help them.

HealthQRS Can Help You Provide Pricing

HealthQRS has developed two powerful solutions, a Retail Medical Marketplace and a Point-of-Service module that can help providers, state governments and health plans provide prices to consumers. Our solutions use a special algorithm to calculate the true out-of-pocket per patient per procedure, not just estimates.

At the point-of-service, as soon as a procedure is authorized and the provider’s scheduler, registrar, financial counselor or front office personnel calls the patient, he or she has a tool to discuss the true cost of the procedure, along with the exact amount that the patient will owe. At that point, the provider’s team member can either collect the full out-of-pocket amount or set up monthly payment plans. This helps providers receive much more than the typical 15 cents on the dollar once a debt goes into collections. Our Retail Medical Marketplace provides consumers with an online format to type in services they need and instantly receive a list of the provider’s procedures, locations and available dates, along with real pricing. Patients can book appointments online and pay in full in advance or set up monthly installments. Both solutions can take payments from HSA credit or debit cards and can track how much is available in each patient’s HSA, allowing patients to easily see and manage their HSA balances.

HealthQRS solutions impact patient behaviors because we empower them with tools they need. We can set you and your patients up to win regardless of the outcomes of healthcare laws. We invite you to learn more about HealthQRS’ solutions. Click here to schedule a demo, or feel free to contact us with any questions.

 

[1] “How Price Transparency Can Control the Cost of Health Care,” Robert Wood Foundation, http://www.rwjf.org/en/library/research/2016/03/how-price-transparency-controls-health-care-cost.html

[2] Ann Boynton and James C. Robinson, “Appropriate Use Of Reference Pricing Can Increase Value,” Health Affairs, July 7, 2015, http://healthaffairs.org/blog/2015/07/07/appropriate-use-of-reference-pricing-can-increase-value/

[3] “Still Searching: How People Use Healthcare Price Information in the United States,” Public Agenda, April 6, 2017, https://www.publicagenda.org/pages/still-searching

[4] https://www.publicagenda.org/files/PublicAgenda_StillSearching_Brief_2017.pdf

[5] Ibid.

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