Doctors may be surprised as hospitals move to bundled pricing

Doctors may have to follow the lead of hospitals when it comes to competitive pricing.

As hospitals compete for patients by offering bundled pricing, doctors may be surprised by being shut out of contracts.

Even if they are employed by the health system, doctors may not be chosen as part of a bundled pricing partnership, according to a Medical Economics report.

Behind the change in how hospitals do business is the need to compete for patients by offering flat-rate, easy-to-compare bundled pricing, according to a PwC's Health Research Institute study released last fall. Physicians with high fees may find themselves excluded from hospital contracts resulting in less patient volume and less revenue, Medical Economics said.

The result of hospitals' shift toward more price transparency is catching doctors by surprise, Cheri Kane, managing director at the Institute and one of the lead authors of the study, told the publication. Hospitals are picking partners in part on how comparatively priced they are, said Kane.

As a result, doctors may also have to think about competitive pricing. "Physicians are not thinking about the price transparency regulations that are coming into play, and they're not thinking how it's going to directly affect their practice," said Kane.

But coming up with a price for what it will cost patients for a particular service can be complicated for physicians, said John Meigs, Jr., M.D., president of the American Academy of Family Physicians.

However, doctors may have to follow the lead of hospitals when it comes to competitive pricing. Hospitals are under great pressure to moderate their pricing, particularly due to media exposure of the cost of certain healthcare procedures; the continued high rate of healthcare inflation in the U.S. compared to other nations; and state and national legislation that can restrain price increases.