Sunday, November 10, 2013

How will you explain pricing to healthcare consumers?

The eight hundred pound gorilla is in the room and it’s not going away any time soon if ever. With the newly insured, current and former patients and the healthcare consumer all facing increasingly larger out-of-pocket expenses for healthcare, how will you explain pricing?

Case in point. A couple of weeks ago I was exhibiting the signs of a heart attack. So after being sent to the ER by my primary physician, an EKG and blood work was done and after several hours I was admitted to the 23 hour observation unit. The other day I received the bill for $23,000 which works out to around $1,000 an hour.  And yes it was sent to my insurance carrier and I have my portion to pay. But there was no explanation of how those charges were determined.  Here is the bill; you owe; so pay it.

But it got me to thinking. I had no idea how the $23K was arrived at and whether or not that was representative of the most accurate value for the care received, especially when the total bill would buy a nice car for that type of money. I mean, a less than friendly radiologist, an arrogant hospitalist who was an internal medicine physician, and a cardiologist who seemed like he did not want to be there added to the wonder if it all. I especially liked being awakened at 12:30 PM for a saline IV that had to be started because a doctor ordered it.  My biggest chuckle was that I could not get a Tylenol for a headache, but there was a physicians order for morphine. Go figure. It’s probably a standard order set and no one is paying attention.
I wonder how many meals I was charged for since I only ate once because no one explained to me that I had to order each meal off a menu and never did have breakfast because of that little omission?

As healthcare evolves to a semi-retail model with the healthcare consumer aka the patient at the center of it all, explanation of pricing, what care and test were provided is no longer something that hospitals, health systems and other providers can afford to ignore.  Can you really imagine going to buy a large ticket item and not knowing all charges? And healthcare is a large ticket item.

This is a reasonable expectation for the healthcare consumer, to be able to know all that was done and how much it cost in detail.  The healthcare consumer is paying more out of my pocket. You can bet they want to look at billing by line item. And they really don’t have the time to chase down with your billing department the detail.

It’s called accountability and it’s a two way street.  Accountability on my part to understand the who, what and where of treatment, and accountability on your part to be price transparent. This will lead to some uncomfortable discussions with the healthcare consumer as they seek to understand it all, but that is why you have a marketing department. They need to be involved by understanding the informational needs of the healthcare consumer, design of the bills and training of staff to handle inquiries.

Healthcare is changing and the old ways of doing business no longer work.  Because if you don’t change billing practices and become more price and treatment transparent, someone legislatively, or through the courts will force you too.

Its your choice on price transparency. Inform the healthcare consumer now, or inform them later when you are forced too. Either way it’s going to happen.

Now where is the address for the FTC and my Senator and Representatives?

Michael J. Krivich, MHA, FACHE, PCM, is an internationally followed healthcare marketing blogger with over 5,000 monthly pages views read in over 52 countries worldwide on Healthcare Marketing Matters. These views are my own. He is founder of the michael J group, a Fellow, American College of Healthcare Executives and a Professional Certified Marketer, American Marketing Association.  Like us on facebook at the michael J group, and connect with me on LinkedIn and Twitter.

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