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    How to provide patients the up-front price of treatment

    Bradley Bullock, MD’s 12-year-old son injured his foot during gymnastics last year and needed an X-ray. Bullock, who practices internal medicine and pediatrics, took him to an imaging facility near one of his practice’s two locations in suburban Nashville. He’d referred countless patients to the facility, largely because of its convenient location.

    A couple of weeks later, he got the bill: $225 for a simple foot X-ray.

    “I was shocked,” says Bullock, who counts himself among the growing number of Americans—now about 30% of employees—who carry a high-deductible insurance plan. “I’m in healthcare, so if I’m shocked, I’m sure other people would be shocked.”

    For everything they buy, from cradles to cars to condos, consumers have the ability to compare prices. Yet while pricing information elsewhere has grown more accessible, in healthcare it remains elusive, even as prices continue to rise.


    An opportunity in crisis

    Lack of price transparency is the biggest problem in American medicine today, says Joseph E. Scherger, MD, MPH, vice president of primary care at Eisenhower Medical Center in Rancho Mirage, California, and member of the Medical Economics Editorial Advisory Board. Early in his career, while in private practice, he offered patients easy price availability.

    “We posted our fees,” he says. “Everybody knew what an office visit cost depending on how complex it was.” That was before the insurance companies began what Scherger calls their “game-playing” of working out deals with providers with little concern for a practice’s fee schedule.

    Today, it’s not uncommon for two patients receiving the same treatment on the same day in the same location to pay different prices depending on their employer and insurance carrier. It’s also common for doctors not only to have no idea what an imaging referral might cost but even what their own services cost, Scherger says.

    Yet in every crisis there is opportunity, and a physician able to offer price transparency today, in the form of listing self-pay prices (and perhaps provide a discount for those paying cash) can save patients money and stand out in the market, he says.


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