Last week, I was checking out of a hardware store when I noticed the doormat I thought was on sale was rung up at a higher price. I asked the cashier about it. She got on the phone and discovered the wrong item had been marked down. But I was given the discount anyway.
That's happened numerous times in my life as a shopper--no one in the retail sphere wants customers annoyed because they believed they were misled.
Yet if you try and get a healthcare provider or insurer to honor their posted price, they will all but laugh you out of the room.
That's why I wasn't terribly surprised to see the NPR report on major health plans offering price calculators. Although more providers and insurers offer them to patients, it turns out they often don't work, and that obviously has a big financial impact on patients. For example, NPR spoke to Kate and Scott Savett, who report they once had an MRI cost them $1,900 more than their UnitedHealth cost calculator estimated because the imaging center was purchased by a hospital, which nearly quintupled its price. Other bills came in as much as $1,000 more than estimated. The couple has a $3,000 deductible, $8,000 in out-of-pocket costs and a tight budget. They put off purchasing a new water heater because of all of these surprise bills.
A UnitedHealth spokesperson told NPR that its cost calculator rates eight on a one to 10 scale, as if that is supposed to be some form of solace. He certainly did not offer the Savetts any refunds, which would have actually been some form of solace.
Moreover, has a hospital that purchases an imaging center or a physician practice ever sent out a notice to patients that it may raise its prices? I've never heard of that happening. But if readers wish to provide examples, I will be more than happy to report on them in the future.
That lack of communication may have a lot to do with lack of accountability. If Wal-Mart, Sears, Amazon or any other retailer regularly published incorrect prices, they'd be pilloried by customers, journalists, the Federal Trade Commission and various state attorneys general. But nothing like that happens regarding the delivery of healthcare. Therefore patients like the Savetts have virtually no recourse.
Note to both payers and providers: If your cost calculators are not nearly 100 percent accurate, they are less than worthless. All they will do is stoke the already simmering anger of patients who believe they are playing against a house that holds all the cards, and that their health and even lives are on the line if they don't play this rigged game.
So, if UnitedHealth says an imaging center charges $500 for an MRI, then that's what patients should pay. They should be able to print out or take a screen shot of the price quote and either get a refund from the hospital or the payer if they are charged more. Or perhaps both should pony up. And if hospitals purchase an imaging center, medical practice or other ancillary provider, they should be required to publicly communicate the transaction and announce any price increases--as well as submit to a grace period before those new prices apply so that any relevant price lists or calculators can be updated.
That's something state lawmakers and regulators should start working on. Because consumers want to get the same fair shake when they purchase healthcare services as I did when I purchased that doormat. For now, they're just being treated like doormats themselves. – Ron (@FierceHealth)