Is Price Transparency For Medical Insurers And In-House Pricing Plans On The Way?
Is Price Transparency For Medical Insurers And In-House Pricing Plans On The Way?
It might not be on your radar yet, but as of January 1, 2021, the CARES Act has begun phased-based medical price transparency. It begins with hospitals, outpatient departments, and ambulatory surgical centers and will expand to include clinics and doctor’s offices. This includes the difference between cash rates and what each insurance provider pays per service.
Cost Ranges
As price transparency becomes more widespread, patients can expect to see a range of costs for various medical services. For example, the cost of a standard consultation could range from $50 to $250, depending on the provider and location. Procedures such as MRIs might range from $400 to $3,500. These estimates can help patients plan and make informed decisions about their healthcare.
Local Tips
- Check your local hospital's website for a list of standard service prices to get a baseline of costs.
- Contact your insurance provider to understand what services are covered and at what reimbursement rate.
- Consider using online tools and apps that compare healthcare service prices in your area.
FAQs
What is medical price transparency?
Medical price transparency refers to the practice of making the costs of healthcare services available to consumers before they receive care, allowing them to make informed choices.
How does this affect my insurance?
While insurers are not yet required to disclose pricing under the current rule, this transparency initiative may lead to more competitive pricing and better coverage options in the future.
Will this affect the quality of care?
Price transparency is designed to empower consumers without compromising care quality. However, it encourages healthcare providers to maintain competitive pricing while delivering high-quality services.
Doctors and medical insurers aren’t currently included in this new federal rule, but doctors must take note.
Consumer’s Want To Know
Medical pricing transparency and consumer protection have been a hot topic of debate for decades. Other than alternative practitioners, very few essential healthcare providers openly share their price lists. While most doctors and oral health specialists provide transparent pricing upon request, most don’t post pricing to their website. Or provide a printed price list.
Why not? It simply isn’t the medical industry standard, but consumers want to know. In fact, 74% of consumers would be willing to pay up to $50 for transparent pricing prior to a procedure.
Insurance Prices Vary Greatly
You accept vastly different payments from insurance providers for the same medical work. This is something you already know, but soon patients will understand this too. Gradually, patients will be able to access a realistic range of rates of cash rates, as well as costs negotiated with insurers.
They will see that sometimes cash prices are higher than what insurance providers pay. This may not be the case for your medical work, but as patients become informed consumers, the line of questioning they ask before they schedule with any medical provider will shift.
The Likely Ripple Effect
One of the objectives of the Hospital Price Transparency Rule is to create competition between healthcare providers, by empowering patients to weigh both quality and budget. In the past, patients have been disempowered to comparison shop, typically choosing with the physician or facility they are referred to.
Once transparency becomes the healthcare norm, patients can shop around for non-emergent care. This will likely create a ripple effect among local healthcare providers, resulting in more competitive rates.
Just like when searching for the lowest rental car rates, hotel pricing, or airfare—a new generation of medical aggregate sites has already been launched. This includes Health Cost Labs and Turquoise Health. While their focus is on the CARES Act, consumer demand for doctors is likely to arise, even if it’s not required by the federal rule.
As a doctor, your patients are already shopping around, and you already have a price list you share upon request. So, while the Hospital Price Transparency Rule rule doesn’t include you—there’s no reason not to provide pricing.
Cash Plan Transparency To Grow Your Business
Medical providers are being asked to consider patients as both patients and consumers. This isn’t the current industry norm, but there are benefits to adding your cash plan pricing to your website.
Both prospective and returning medical patients are searching online in an effort to comparison shop. Most are only able to access nationwide or regional price ranges within a $400+ price range per procedure. Add your pricing to your website and you are likely to rank higher in your local online search results. Also, your transparency provides a competitive advantage by building consumer trust.
Weence Can Help You Digitally Capitalize On Medical Pricing Transparency
As a digital marketing firm that specializes in the unique challenges and marketing restrictions that doctors face, Weence is all for price transparency. We take a strategic approach to help you grow your business, which includes helping you populate in local area search results.
Medical work pricing trends in every state and region, so by adding an SEO-optimized pricing page, you can answer consumer questions, improve your page rank, and book more patients. We invite you to reach out today to learn more!
