Health iPASS Insights

Opening the Financial Black Box in Healthcare

Posted by Imran Ahmad on Jan 19, 2018 1:48:14 PM

healthcare price transparency

What you don’t know can’t hurt you, right? This idiom has been at the forefront of society’s negative feelings towards understanding the cost of healthcare for far too long. From a patient’s point of view, the "black box" of mystery and confusion surrounding the price of medical procedures can be frustrating and confusing considering their rising responsibilities to pay more from their own pockets for the cost of care. 

In the old days when insurance picked up most or all of the tab for our healthcare bills patients may not have cared as much about cost. However, now that they have more financial "skin in the game" due to the sharp rise of high deductible health plans (HDHPs), they want to know more about how much things cost, and what they are responsible for paying. 

Consider this for a moment: Medical expenditures constitute 18% of U.S. gross domestic product (GDP) but healthcare is the ONLY industry where consumers (and a lot of physicians) seem to have little to no information on what things cost. This has created an incredible amount of administrative waste and a general lack of trust between the patient and the industry. 

The good news is that times are changing. The push for more healthcare price transparency is slowly opening the "black box", deconstructing patient/provider mistrust, and empowering patients to make more educated decisions about their care, even if it means electing to not receive it at all. 

In lockstep with the rise of healthcare price transparency are the design and development of patient-centric payment systems that build trust by empowering patients with financial information about the cost of care and....wait for it...even will display cost estimates of what a patient may owe post insurance claim adjudication.

Wait...what? You mean to tell me when I go to the doctor for my next orthopedic follow up appointment that I can clearly see not only what I may owe in deductibles, co-pays or co-insurance, but I can also see what my insurance will cover and a balance I may be responsible for paying? Unprecedented!

Exciting times indeed.

The biggest problem that both patients and doctors/physicians faced is that until recently, no one really knew the true cost of care. Now that the industry is pulling back the curtain and becoming more price transparent and an increasing amount of medical practices are adopting patient payment solutions that support convenience and build trust, we are witnessing a revolution that's finally aligning cost with value.

If you think about it, the only true remedy for removing the back box surrounding healthcare costs is full disclosure. For example, we previously wrote about how Colorado recently passed a law requiring providers and hospitals to publicly post prices for their procedures. As we noted in that post, we expect to see more states follow suit and pass similar laws that raise price transparency levels and empower patients to better understand and be responsible for the cost of their care. 

Is it time for your medical practice to consider adopting a patient payment solution? Drop us a line and see how we can help.