The Great Healthcare Transparency Movement?
The ability of consumers to shop for healthcare services based on price and quality won't take hold until innovative providers take some risk and a dose of faith.
This article first appeared in the May 2015 issue of HealthLeaders magazine.
Why can't it be easy to shop for healthcare services? All too often, it is a Kafkaesque experience. There's no single place to go.
As a patient, you can't easily compare prices for services as you would when buying a TV. You can call your insurer—which really sets the prices—and you might make some headway, only to then run into brick walls. When you're pointed back to your physician's office for a code in order to continue discussions with the insurer regarding your obligation for, say, a colonoscopy, you'll circle back into discussions about codes and preventive and elective care. You might get it resolved before your scheduled procedure. You might not. For most patients, that is the world of healthcare billing as it is.
All this despite the fact that each of the three key players in the healthcare transaction—the payers, providers, and employers/patients—agrees that patients should be able to receive accurate price estimates for healthcare services prior to consuming them. But bringing that vision to reality is considerably more complicated than it may seem.