It’s Time for Doctors to Consider Medical Costs

April 28, 2014 in Member Stories

TIMOTHY GOWER’s article, “Should doctors consider medical costs?”  (Boston Globe, Ideas, April 13) should serve as a wake-up call about the state of transparency in our health care system.

It should be required reading for everyone touched by our healthcare system whether you’re a   consumer, a business, an insurer or a provider.  Gower takes us through the story of a woman who was on the precipice of a potentially fatal medical emergency and was reticent to receive care until she received a quote for her ultrasound. The reason?  She was still paying off skyrocketing bills from tests ordered at an earlier visit that may or may not have been necessary.  The doctor, growing more concerned by the minute about the health of his patient tried to chase down the figure for this routine test. It took him a day to get it from the hospital. He received the figure and the patient relented and accepted the treatment.

The lack of transparency and information surrounding health care costs has resulted in some consumers making uninformed and sometimes risky decisions.  Gower points out that some patients may forgo treatment because they are uninformed about lower-priced options for medical services, including tests or routine procedures. When a person’s health is at stake, having information readily available about options and costs is very relevant to the decision-making process.

We know that high deductibles and co-insurance are becoming more common in health plans especially for small groups and individuals. Even with healthcare reform, there are large differences in out of pocket costs among various types of policies.  In 2012, Governor Patrick signed legislation that requires both carriers and providers to give price and out-of-pocket information to healthcare consumers within two days of a request. By this October, insurance companies will be required to provide this information in real-time. For more and more consumers this information is very important.

Empowering healthcare consumers through price and quality transparency is the wave of the future and providers must play an integral role in this, particularly given the trust that many patients place in their doctors’ recommendations.

Doctors, hospitals, and other providers have a responsibility to be prepared to talk about healthcare costs with their patients and potential patients.  As consumers, we expect to know price estimates before making a selection for a variety of services and we should be able to expect the same from healthcare providers.

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