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Medical price lists and transparency… and possibly a new Michigan law that will encourage both

April 7th, 2016

“If you have to ask the price, you can’t afford it.” Thus goes the saying when shopping in high-end retail stores. This might often be true for healthcare shopping as well, but the challenge would be to actually get an answer on price, not just the affordability factor. Why are buyers kept in the dark on the cost of their medical purchases? As they incur a greater percentage of their healthcare costs, shouldn’t they be able to price shop a mammogram or colonoscopy like they do an appliance? I have been lamenting for years the need for a patient price list for services – and recall telling a medical reporter about eight years ago that we’d be seeing such price lists in the near future. Good thing I don’t make my living as a clairvoyant!

As consumers assume more of the their own healthcare costs, the healthcare community (insurers, physicians, hospitals and diagnostic and ambulatory centers) need to step up to the plate and publicly share and post the pricing of a service, as well as any ancillary costs such as radiologist or operating room fees. Historically, consumers depended on insurers to pay, regardless of cost, and there were no need for public price lists. Only since the advent of the Affordable Care Act and mandatory insurance rules, with consumers paying higher deductibles and co-pays, has the topic been seriously broached.

Now, there are glimmers of hope. New Hampshire offers a website that let’s healthcare consumers compare costs on specific medical procedures and recently added the costs for pharmaceuticals and dental procedures. Closer to home, Priority Health’s newer cost estimator tool is allowing plan members to compares costs at different medical facilities for services such as X-rays, MRIs and other common services. Moreover, patients not only learn what their out of pocket costs will be, they receive gift cards as a reward for making smart financial choices. It is my understanding that Blue Cross Blue Shield of Michigan is planning to introduce price lists next year as well.

Interestingly, in the throes of writing this blog post, I read that a Michigan law has been proposed (Senate Bill 147) by State Senator Joe Hune that would require hospitals to publish a master list of fees for services, procedures and medical supplies. It’s all in the name of transparency and it’s long overdue. But wait, the article also referenced a similar bill introduced by Hune in 2013 that ultimately went nowhere.

As a recent study in California showed high-priced care does not always equate to high quality. Tell us something we don’t already know, right? Our own PO has been referring patients to reputable freestanding clinics and diagnostic centers for decades as a trusted alternative to the growing cost of hospital-based services. Maybe we need more POs to lead the charge in this effort. Senator Hune, you’ve found some allies.

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