Why Don’t Doctors Usually Post Costs?
May 30, 2019 Written by: Costectomy
If you’ve ever tried to find the price of a medical procedure or consultation beforehand, you might have realized that it’s almost impossible to get an exact quote! Doctors and hospitals rarely post prices in an accessible way. . It sometimes feels like an elaborate ploy to keep patients in the dark and charge crazy amounts of money. . However, when you dig deeper, the truth is more complicated – and definitely not as sinister.
In the United States, healthcare is run like a business. Doctors do not price medical procedures and services. Most individual practices and hospitals are in fact a part of larger healthcare networks and conglomerates. These networks negotiate with insurance providers to set prices for each medical procedure and service. Out-of-network practices, or medical clinics that do not set prices with an insurance company, still need to factor in insurance rates and coverages; their patients bills’ are usually paid by their respective insurance agencies.
Secondly, healthcare is an intricate and sophisticated process. A single hospital visit may involve the services of different specialist physicians and consultants, nurses, and various medical technicians for lab-work, imaging, and anaesthesia. To further complicate matters, each step in a treatment depends on the previous diagnosis and treatment; you can’t really predict the shape of a treatment pathway from the beginning. Lab results, imaging reports, and physical examinations are all different steps that help shape the final treatment plan. Since it’s often impossible to predict the nature of the treatment, it’s often impossible to give an exact price.
Despite that, there is an increasing emphasis on cost transparency in healthcare. Since January 2019,, hospitals and practices are required to post their prices online. However, there is no penalty for not posting prices; many hospitals have yet to implement this regulation. More worrying, however, is that even with hospital price transparency, the average patient may still be unable to comprehend the pricing algorithm. Since hospitals can only show the prices of each individual step rather than the whole treatment plan (which they cannot predict for each patient), the result is often endless lists showing prices for thousands of items. These lists are unhelpful; forget the average patient, even physicians can’t decipher them! Such lists are not much help
Costectomy understands this transparency dilemma. It’s revolutionary agenda is to cut the insurance middle-man out completely and give the purchasing power back to the people – and their doctors. Patients and their providers should be empowered to decide their service payments and charges in a collaborative and direct manner Costectomy enables doctors and practices to post clear prices for their services. Patients going to these clinics will know well in advance how much they will pay and what services they will get in return. Without the middle-man, healthcare is bound to become not only more affordable but much simpler for everyone involved.
- Vineet Arora, Christopher Moriates, Neel Shah. The Challenge of Understanding Health Care Costs and Charges. AMA Journal of Ethics. https://journalofethics.ama-assn.org/article/challenge-understanding-health-care-costs-and-charges/2015-11. November 2015. Accessed 25 May 2019.
- Julie Appleby, Barbara F. Ostrov. As Hospitals Post Sticker Prices Online, Most Patients Will Remain Befuddled. Kaiser Health News. https://khn.org/news/as-hospitals-post-sticker-prices-online-most-patients-will-remain-befuddled/. January 4, 2019. Accessed 25 May 2019.
- How to Research Health Care Prices. The Wall Street Journal. http://guides.wsj.com/health/health-costs/how-to-research-health-care-prices/. December 4, 2009. Accessed 25 May 2019.