A Patient-Centered Approach to Price Transparency in Healthcare

By: on October 15, 2019

Chances are good you’ve recently heard about a push for price transparency in healthcare and an end to surprise medical bills for patients.

Earlier this year, after the President made comments about protecting patients from receiving unexpected bills after seeking emergency or non-emergency medical care, Representatives Frank Pallone of New Jersey and Greg Walden of Oregon jointly released a draft bill to do just that.

What’s more, this legislative effort has tremendous support from Democrats, Republicans, and Independents alike.

If you’re an independent medical practice, you might be wondering how this will affect you. To answer your question, we ran a survey of U.S. patients to find out how they feel about medical billing and medical price transparency.

Patients wish medical pricing information was more accessible

One of the biggest themes in our survey—and, coincidentally, the easiest actionable takeaway for medical providers—had to do with providing clear and easy access to pricing information.

We asked patients how accessible they felt medical pricing information was for their regular medical providers or local doctors’ offices. Nearly half said it wasn’t.

Software Advice Survey: patient access to medical pricing information

That’s a big deal for a few reasons, not the least of which is it causes patients to leave practices to find new doctors who will communicate pricing.

No need to panic, though; the next thing we asked patients in our survey was how they wanted doctors to communicate cost information, and we have some simple, implementable solutions as a result.

Patients want to know the cost of services before they get them

What it boils down to is this: Patients want to know what they’re going to spend before they’re on the hook for it.

Knowing the cost of a good or service before you commit to paying for it is the norm in nearly every other market, and patients are starting to expect the same from medical care as well. This explains why concierge medicine is a growing model for practices these days. Patients like knowing exactly what they’re going to spend on healthcare.

Whatever the reasons are, the end result is the same: Patients want price transparency in healthcare.

We asked our survey respondents to rank a list of methods practices could employ to better communicate costs. Discussing the cost of procedures like blood tests and prescription drugs in-person before ordering or prescribing them was ranked the highest.

Software Advice Survey: patient preferred strategies for communicating cost of care

This makes sense in the context of shared decision making and it’s growing popularity among U.S. patients. They want a say in their medical care, and that applies to making financial decisions as well.

Most patients have received confusing medical bills, and they’ve left because of it

Our survey also found that not understanding medical pricing was a major source of frustration for many patients.

Software Advice Survey: patients have experienced issues with medical billing

Confusing medical billing was enough of a factor, in fact, that it has led patients to leave medical practices.

While there’s not a lot independent practices can do about the biggest cause of patients leaving practices (cost of services being too high), physicians do have control over the number of mistakes on medical bills and how clearly charges are explained to patients.

So many of the issues patients have around the cost of care can be resolved through price transparency—even something as simple as a quick conversation about how much patients should expect to spend or an itemized bill.

Software Advice Survey: top cost of care related reasons patient leave medical practices

Another common theme in this survey question came from the “other” answers in which respondents were able to write in responses. We found several references to insurance-related issues. When asked why patients moved to a new medical practice, these were some of the answers we got:

  • “I changed insurance companies”
  • “My insurance company required it”
  • “Insurance company insisted”

This indicates how critical it is for practices to choose wisely which insurance providers they’ll accept.

Medical billing is not a simple thing, and there’s no simple solution to the problems around it. That said, having a good working relationship with insurance providers and understanding all of the reporting requirements for Medicare reimbursements will go a long way to simplifying your life.

So will having a medical billing system that serves your specific needs. If you’re not already using a billing system and want to find out more about this software, reach out to our team of medical advisors to discuss providers that will fit your practice’s specific needs.

Methodology and demographics

We conducted a survey in September 2019 to collect the data presented in this report. We used screening questions to narrow the number of respondents down to 284 with the relevant experience to answer our questions.

If you have comments or would like to obtain access to any of the charts above, please contact lisa.hedges@gartner.com. You can also find the author on Twitter. For more information, see our methodologies page.

Note: The information contained in this article has been obtained from sources believed to be reliable.

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