HealthCare Partners, a 400 physician multi-specialty group in southern California, has posted fees for about 60 services on their website. The article in the LA Times suggested that part of the reason may be to counteract the spread of retail walk in clinics, which are often perceived as being less expensive than a physicians office.
President Bush and company are convinced that making fees widely available will somehow help control the growth of healthcare costs. This notion is sheer nonsense, of course. This administration is only focused on the costs to employers, ignoring the increasing portion of costs borne by patients. Patients, and wisely so, would be willing to pay more for quality. That said, healthcare, in particular, is viewed as what economists would call a “social good”, where a pure market economy should not and will not operate.
I’m not convinced that putting all fees on a website is going to impact consumer, nor serve any real value in a competitive marketplace. On the other hand, I would make fee information readily available, particularly when big ticket services or procedures are at stake. About a year ago, I had occasion to call one of our local teaching hospitals about an MRI. It took two days to get the one person who could help me to call me back, and even then they couldn’t give me a price for the procedure (which would lead to my out of pocket cost).
The take-away: physicians are going to have to be able to tell people, in advance, what the fee will be for most services. It doesn’t necessarily mean that we will lose patients to someone cheaper – although that will sometimes happen. Quality – or perceived quality – and patient service will trump cost to a point. To charge higher fees, however, we will have to earn it. As for third party payers – well, there will be measures, of some sort, and bonus payments, beginning with Medicare’s program this summer.
Making fees readily available may be new in healthcare, but there is no reason why, with the numbers so big, that patients are hit with a surprise a month later. Most times, a physician can’t always estimate the fees, because it’s only after they figure out what’s wrong will they know what it will take to help the patient. As with Health Care Partners, the posted fees can only cover common services. As a patient, my impression was positive – I have a feel for what a visit will cost. The fee sheet also has links to child and adult immunization schedules, which is a good reminder that I should also be aware when to ask about what I need.