Although by many accounts physicians have traditionally resisted discussing healthcare costs directly with patients, it's becoming increasingly clear that an updated definition of patient care will have to include helping patients factor out-of-pocket expenses into their medical decision-making.
In a recent piece in the New York Times, Dr. Jeffrey Kullgren, an internist and clinical scholar at the University of Pennsylvania, gives patients specific advice on how to approach cost discussions with their doctors. Whether talking about money with patients is something you're comfortable with or not, consider the following advice to patients and how you plan to address such scenarios in your practice:
- Consumer tip 1: Bring up finances early in the visit to allow time for discussion. Be prepared for this subject to come up and plan how you will handle it. This may mean scheduling extra time for a visit during which you plan to recommend costly tests or treatment options. Alternatively, acknowledge that cost is a concern for the patient and indicate when you will be able to discuss it further.
- Consumer tip 2: Speak directly to the physician who orders the service, not the employee who handles the billing. Realize that patients today are interested in controlling costs on the front end--before undergoing tests or procedures--and not just on figuring out how they'll pay for services after the fact. As one commenter on our new LinkedIn discussion board aptly pointed out, it may be more efficient and satisfying to the patient to have a patient advocate in the room to discuss cost-of-treatment decisions as a group, during the visit. "A patient does not get to step out of the room, speak to the front office and then go back into the exam room and finish up with the doctor," she notes.
- Consumer tip 3: Ask for discounts. Patients are increasingly aware that large insurers negotiate discounts with providers, but are nonetheless uninformed about the nuances of what contracts and various billing laws allow them to do. Don't be blindsided or offended by these inquiries. Even if you can't tell a patient what he or she wants to hear, have answers to these increasingly common questions prepared in advance, in a way that is clearly understandable to people outside the insurance or healthcare industry. Have information about your charity care policy and eligibility readily available, as well.