The perils of price lists for private practices
Price projections versus reality
Patients also need to understand that a price for a single procedure may not be all-inclusive.
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“It’s analogous to fixing a car,” says Hollister. “You go into the shop because your clock doesn’t work. The mechanic says, ‘I don’t know what’s wrong, I have to diagnose it.’ The same thing happens in a doctor’s office. I can say that a code includes an evaluation of the problem, and if the solution is very simple, then the pricing is easy. But the patient may require additional lab work, an injection of medication, a prescription, and so on. I think people can understand that.”
As the need for tests, treatment, procedures and therapy grows larger, however, some patients may view each additional requirement as a hidden fee, just as they might view mounting costs at their mechanic’s shop. To find ways to be as comprehensive as possible with patients, some of the pricing techniques used in retail may find their way into medical practices. For example, retailers often bundle all of the potential costs of a product purchase, including the product, service contract, warranty and accessories in one price. Physicians may find a need to do the same.
This is the approach taken by the Surgery Center of Oklahoma, a multispecialty facility in Oklahoma City, where about 40 surgeons and anesthesiologists share ownership. At the center’s website, patients can click on an illustration of a body part, choose the surgery they need from a drop-down menu and get an instant price quote. The pricing includes the facility fee, surgeon and anesthesiologist fees, as well as the initial consultation and routine follow-up.
The website’s disclaimer itemizes the things that are not included in the price as well. “Our experienced surgical staff knows with almost certainty what will be needed to complete your surgery,” it confirms, but if hardware or implants are part of the procedure, they are provided “at invoice cost without any markup whatsoever.”
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As Damle and Hollister note, however, if the patient’s insurance will pay for the procedure, it’s an entirely different story. This holds true for the surgery center, as evidenced by their disclaimer: “If you are scheduled for surgery at our facility and we are filing insurance for you, the prices listed on this website do not apply to you.”
So while physicians know their fee structures and can provide price lists to patients if required to do so, only those who are not covered by health insurance are likely to find this information useful.
“The informed consumer is one thing,” says Hollister, “but when consumers have information, they don’t always know what to do with it. Or if they do, that doesn’t mean they get charged less. What does the patient get for what they’re paying? That’s what is most important.”
Randi Minetor is an author and freelance journalist based in upstate New York.