The perfect patient finance app


Now that Facebook has gone public, the only relevant question about this enterprise is finally being asked: Why should something that encourages you to take and post stupid pictures of yourself be worth anything?

If someone truly wants to make legitimate billions actually pairing people with worthwhile information, create an application where you can:

1. Call up the chargemaster of any provider before you walk in the doors and …
2. Empower patients in provider communications.

At the moment, neither is available. I checked the Google Play Market and the Apple App Store. I also reread my annual "iPad apps that could arrive before Christmas" column. Nada.

Which is a shame, particularly considering two recent distressing missives that affect healthcare finance. The first is a new study by the Palo Alto Medical Foundation Research Institute and the Dartmouth Center for Health Care Delivery Science. The study's conclusion: Patients are afraid of their doctors.

"We found that patients want to participate in making decisions with their physicians, but feel vulnerable and worried that they might be perceived as too assertive, resulting in lower quality care in the future," lead researcher Dominick Frosch said in a statement.

The second is by Chad Terhune, a former Wall Street Journal reporter who recently got the healthcare gig at the Los Angeles Times. His report is a little startling, even for me: Many hospitals offer cash-pay patients better rates than those with insurance.

First, let's discuss the physician/provider issue. No one should particularly care if they're assertive with their doctor. People learn through hard experience that they're least satisfied and most likely to kick themselves if they remain passive. Nevertheless, they steadfastly continue do so when it comes to their health and healthcare providers.

Like everyone else, my out-of-pocket costs for healthcare have soared in recent years. I spend more than $600 a month on health insurance for my family, and often have to shell out hundreds more for office visits. I could tool around in a Mercedes or take a really nice vacation each year for that outlay, so I better get some value from it. In such a context, it's clear who should be serving who.

Most doctors are mildly surprised if I evince skepticism. They may initially bristle if I push back. But since I don't ask stupid questions, I usually get grudging respect.

Which brings me to the price issue. According to Terhune's article, at one Southern California hospital, the cash price for a CT scan was $250. Its price on a state-run website: $4,423. For my insurer Blue Shield of California, it's $2,400.

Pushing back with doctors is of a piece with negotiating the best price. Blending skepticism, confidence--and most importantly, accurate information--is the only way to seal a deal where you know you're not getting the shaft along with those sutures. And as I've said before, if you don't screw your patients over with the final bill, they'll be much more willing to pay it.

At the moment, only some of these elements are available, and it seems none are ever in the same place. Given the mounting financial pressures being placed on patients, that's going to have to change. And since I apparently have to have the ability to code in order to decode stepping through the hospital doors, it's going to have to be up to somebody else. If there's a useful Mark Zuckerberg out there, you're on, pal. - Ron (@FierceHealth)

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