With many patients still struggling to manage their healthcare expenses, doctors are overcoming the traditional taboo against discussing money in the context of practicing medicine. Now that it's no longer a given that insurance simply will cover the bulk of the care they receive, patients also are taking responsibility for seeking value in healthcare, and they increasingly have more tools to do so.
It's not only patients paying out of pocket that are driving the cost-comparison trend. With a recent study showing that the cost of some preventive exams can vary by up to 700 percent, as reported by USA Today, insurers and employers want patients to shop around, as well. The Safeway grocery chain, for example, provides its employees with cost-comparison information for medical procedures, for which the company will only pay a set amount. If an employee gets a procedure that costs more than budgeted by Safeway, he or she has to pay the difference.
Similarly, the Arizona Republic reported that private insurance companies increasingly are offering patients, with and without insurance, robust online data about healthcare quality and cost.
Cigna, for example, unveiled a new website in February that allows consumers to search costs for 200 common medical procedures and estimate prices for specialists, doctors and hospitals based on their specific coverage. The website also lets customers estimate how much a doctor would charge based on performing the same procedure at different hospitals.
These resources also are available to physicians and can help them prepare for patients' inquiries as to why a given practice may charge more or less than the going rate for a service or procedure and how other factors, such as the complexity of a case, may affect cost.
What's more, consumer advocates have for years urged patients that the "sticker price" of healthcare is negotiable and provided steps for beginning the discussions. As physicians, it's up to you to determine how much leeway you're willing to give within the constraints of what your payer contracts allow. Making your financial and hardship policies clear and well-publicized also will show patients that you are willing to engage them on the subject of cost rather than losing them to a competitor with lower prices.