- 599
What sort of change would it make for the consumer? The issue isn't how much a doctor charges for a specific procedure. It's how many procedures they bill for.
Medicare PartB Payment to Dr Revealed
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What sort of change would it make for the consumer? The issue isn't how much a doctor charges for a specific procedure. It's how many procedures they bill for.
- 11,996
You and I have very different perspectives on what the issue is.
From my view most consumers don't view healthcare as a service, they view it as God's appointed angels and considering the payment amount is blasphemy. For example:
Average consumer gets a flat tire and needs a new set of tires. Most of them are going to price shop and talk to a few shops before deciding who they'll go with. We're a very price driven society; that's why Walmart does so well for themselves. All of the sudden we forget that when we're talking about healthcare. Hell, even when it comes to a dental procedure or an eye exam we'll shop, but most folks never even ask what the providers bill out at. One thing Part D did a great job of was creating a tangible reason for the consumer to think about the actual cost of prescriptions each pharmacy charged vs just looking at the copay. If the sign on the wall said office visit was $300 it might accidentally put some value on their $20 copay. As soon as most people read on their EOB "this is not a bill" none of it matters.
The cost of getting healthcare shouldn't be the only determining factor in what care people receive, but it should at least enter into the equation.
- 599
The cost of the healthcare has very little direct effect on the consumer unless they're paying OOP. With dental and vision, most of the time the providers can charge whatever they want and the insurance company only pays a set dollar value no matter the cost. There is a true difference in that case.
With medical, the insurance company really decides the price. Our local bc/bs does have a way of lowering costs by tiering doctors and hospitals-charging higher copays if the pt goes to a more expensive doctor. I think that is a fair practice as it does affect the patients care. Telling the patient a random amount that the office would charge them if they didn't have insurance doesn't mean anything other than that it's good they have insurance.
- 11,996
I think you're missing my point altogether. I want the customer to have to at least look at the price and give it some thought.
You and I are probably also going to disagree on this a great deal. If consumers knew that Bob Smith charges $300 for an office visit and they had a $25 copay they would appreciate that more and might see why costs go up. If they know that Bob Smith charges $300 and they know that Tom Roberts charges $200, it might have them think twice about where they're spending their deductible and such.
- 599
No, your point makes sense in cases where doctors might actually be paid differently. But if I was a doctor, and I could tell you that my services would normally cost $500 but you can get them for a $20 copay and Dr. Josh down the hall charges $300 for the same procedure and still charges you $20, well you're getting a better deal going with me. And I must be a better doctor because I can charge so much more. Win-win for me.
- 11,996
There are a lot of presumptions on there.
Folks should be thinking about the cost of their healthcare and they're not.
- 599
You're right. I'm just disagreeing with what dollar value is important. What the patients should be aware of ahead of time is their out of pocket cost. Which has very little to do with the full price a doctor would charge.
- 11,996
I think patients dip consider their out of pocket, but that's not anywhere near enough. One of three problems is that the only thing they care about is their out of pocket. They don't consider the difference in cost from one provider to the next. Hell, many think the ER is the only place for urgent care vs actual urgent care facilities. If the consumer saw a sign on the wall for office visits, diagnostics, or anything else at even the simplest level they'd see the hard cost of care and might think and behave differently. Part D got millions of seniors to actually think about what the pharmacy was charging vs just the patient out of pocket.
- 599
Having worked in pharmacy, unless they're working with someone who can explain the system to them, it doesn't make the majority of them think about the price until they hit the coverage gap. Then they think about how to get the meds cheaper, not about how they could have had a cheaper alternative.
Having cash price signs up in the office may prevent some people from over utilizing services, however it will also confuse a similar percentage of people out of getting coverage they need. And the rest won't care because "their insurance is covering it."
- 11,996
IF it took them that long to think about it they never saw one of my presentations.
If they realized it then, they realized it.
IF the sign was up and specifically had in bold the same font as the prices that their prices may be as low as nothing depending on insurance or some variation of that it would help achieve the same goal.
Again, consumers don't even think about the cost of healthcare and to me that's a huge problem; how can you value something you don't even see the price on. It's "free", so why does the premium keep going up?
