The cost of health care in the United States remains a challenging puzzle for patients and providers. Absent of clear, easy-to-understand pricing guidelines that span across state lines, many struggle to determine the actual price of a medical procedure. Even the simplest of questions —what is this going to cost? —is often buried in red tape and obscurities, making it difficult for patients to receive the care they need and for physicians to recommend the best solutions.
“People don’t always have an accurate understanding of what their health care is going to cost,” according to Dr. Turner. “I’m trying to think of another industry in which you get the exact same product, but just based on the location, it costs three times as much to do it in a different location.”
Understanding cost means understanding care
Without an awareness of the cost of care, it can be difficult for patients to make important decisions. Dr. Turner recalls a procedure that carries one price at a clinic but costs three times as much at a hospital. In an effort to control costs, Dr. Turner finds patients attempting to negotiate essential aspects of the procedure, asking questions like, “Can you do it in the clinic without anesthesia?”
“One of our major problems in our society is the cost of healthcare,” says Dr. Steve Overman, a physician and Professor of Clinical Medicine at the University of Washington Medical School. In the modern era of huge deductibles that impacts patients directly on the front end, Dr. Overman believes providers working in these systems need to push toward a higher value of care. To do so, physicians must understand the true costs of care for patients.
Stay in touch
For physicians, many of whom have been employed for several years, Dr. Turner believes it’s easy to lose touch with the actual cost of care. “It’s embarrassing for me when I recommend a procedure, and the patient asks me how much it’s going to cost,” says Dr. Turner, “And I say, ‘Hey, there’s a member of our financial services team,’ who actually I don’t even know, and they’ll give you an estimate of what it’s going to cost you to go get this procedure.”
When attempting to comply with the mission of controlling costs, Dr. Overman’s trouble when costs change without notification. “If I have no idea that the ANA panel that I just ordered cost $300, and I could have ordered one subgroup that I was interested in for $20,” says Dr. Overman, “how am I even going to be able to think about that if that information is not brought forward?” These issues can become even more complicated when physicians have additional financial interests in things like ambulatory surgery centers, in which they may be inclined to inappropriately push procedures onto clients.
Clarity is care
Providing the best outcomes for patients requires physicians to understand the true cost of care. “Because when they’re acting in compliance and they’re acting ethically,” according to Dr. Turner, “people know that they’re getting what they’re paying for.” The best and most ethical companies are confident enough to be transparent, and by providing a clear illustration of the overall cost of medical care, patients will be able to make informed decisions with their best interests at heart.