par John W. Mitchell
, Senior Correspondent | March 07, 2016
Dr. Jonathan Kaplan, a board certified plastic surgeon, maintains that most patients are “price unaware” when they seek non-emergent health care. He said this is true for such procedures as imaging scans, laboratory work, orthopedic procedures such as joint replacement, and dermatology.
“Most doctors and hospitals don’t help by providing good pricing information that is actionable by patients," said Kaplan. "Hospitals and doctors take one of two positions on this problem, neither of which works very well.” He presented these ideas at a HIMSS 2016 session titled, “Price Transparency: Bringing Providers to the Table."
According to Kaplan, providers either decline to discuss pricing over the phone, referring patients to websites or telling the patient to make an appointment. Or they spend a lot of time discussing pricing and never hear from the caller again.
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To address this problem in his own practice he developed an app in 2011 to help patients gather information on their own plastic surgery interests, and expanded the strategy to a website widget.
Two years ago, he launched the combined platform “Build My Bod”. To date, about 150 doctors and a hospital in Louisiana – Our Lady of the Lake Regional Medical Center – have adopted the platform to assist patients in making health care spending decisions about non-emergent procedures.
Using the website and app, Kaplan said that patients can shop from a host of procedures that very clearly list the bundled pricing components. For a joint replacement, he said, that would include the surgeon fee, anesthesia fee, hospital charge and rehabilitation costs.
He said in his own practice, for example, that “price aware” patients who had used the app and or website widget, were 41 percent more likely to follow-up by booking a procedure.
Kaplan told HCB News that a trio of trends gave him the idea to make things easier for patients.
“The federal and state government are pressuring providers to be more price transparent,” he said. “Also patients who get frustrated when they can’t find good pricing information are leaving markets as medical tourists, attracted by good pricing transparency. And high deductible plans and out-of-pocket costs are making patients more price sensitive.”
He said that providers who do the best job of satisfying patient pricing demands would win over patients.
Under the ACA, hospitals are required to provide pricing information. But this regulatory element of the ACA has been slow going. CMS released proposed rules in 2014. Both the American Medical Society and the American Hospital Association support the concept of price transparency on their websites,
However, Kaplan said the reality is that any hospitals that list prices, list charges, rather than actual negotiated prices that a patient might pay. This, he maintains, is not very useful information when people are trying to make a decision about spending thousands of dollars out-of-pocket, or to meet their deductible.