Healthcare Savvy

I’m not speaking for Dave, but he has said that he prefers the term “visible pricing” over “transparency.”

Fascinating! I don’t suppose you plan to provide updates during your trip, such as through Twitter?

Of course, the solution would be for the Minute Clinic to add another physician’s assistant or nurse practitioner to handle the busy times when there is a line, but keep in mind that they can’t just add in an extra person for certain hours and each is likely a $60,000-80,000 yearly expense for them. I’m [...]

I think many docs fear that it would be the unhappy people motivated to post reviews/ratings, although that might not be true in reality.

If I only had the time to be able to complete my documentation before each vist is completed. Unfortunately, there are usually more patients waiting. Most doctors have to complete their notes after-hours. Of course, one answer is to schedule fewer patients, but people don’t like to be turned away when they need us. A [...]

To address one point of this post, having an A1c test is not “preventive.” It is a test to monitor a chronic disease–diabetes. Even though one may not be “sick” at the time, and even if it is routine for the situation, it is still not considered prevention. It is follow up or surveillance of [...]

Our multi-site group has set up a situation where our most central site essentially converts into a first-come, first-serve urgent care type of service from 5:30-9:00 PM weekdays and from 9:00 AM to 9:00 PM on weekends. It is open to all patients, but is especially valuable to our group’s patients because there is access [...]

As a physician I have had surprisingly few patients “haggle” on charges, but the ones who do make cost-reduction efforts have shown me the right way and the wrong way to do it. Instead of haggling or creating an awkward situation for all, the best tactic is to politely mention early in the visit that [...]

Even trying hard I can’t think of enough tests to appropriately perform on a healthy 21-year-old that would add up to $500, much less $3600.

Would you be willing (without revealing any personal information) to list what tests were ordered?

Amy, You are raising an important point. The question you are asking relates to the Number Needed to Screen. Simply, how many colonoscopies would need to be performed on individuals at low risk for colon cancer (instead of sigmoidoscopies) to save one person from dying prematurely from colon cancer? Obviously, if it only took two [...]

You found out what many people don’t know. The co-pay can be more expensive than the cost of the medication. Admittedly, there aren’t a ton of meds costing less than $15 per month, but there are some. It can pay to ask “what would this cost if I paid cash for the entire price?”

That obviously is a huge difference in cost. It appears to be a function of charging what the insurance market will bear. I’m not saying it is right, but practices/hospitals will try to get as much as they can, where they can, to make up for losses elsewhere. Hospitals in particular provide an incredible amount [...]

See if this is what you are looking for:

http://www.acepnews.com/news/practice-trends/single-article/study-knowing-costs-affects-lab-test-ordering/e3465f4d2a074eb58adeac533e477ce4.html

I’m trying to think of a ten minute outpatient procedure that would cost $800 and I haven’t come up with one.

Adrian, it is up to each practice/facility to determine whether and how to convey their pricing. My assumption is that few post prices publicly, but pricing certainly should be made available to those who ask. Unfortunately, that is not always the case.

By the way…

Eli, you are a good man to allow your mom to post that picture. If you didn’t get an iPhone out of it, negotiate harder next time.

It sounds like to go well beyond what is expected of you in helping your patients minimize their health care costs. I’m sure your patients are very appreciative.

I agree that current incentives are not necessarily aligned with desired outcomes.

(I am not defending the system. Just trying to explain it.) There are two primary reasons why the braces example is fairly transparent and straightforward. First, there are only two entities involved, the orthodontist and your insurance company. This reduces the number of variables to consider. Many medical services involve more players…[Read more]

Stephanie, I reviewed the additional details of your efforts (see link provided by Ms. Bebinger above) and I must say that you have done an excellent job in attempting to sort out the estimated costs of the procedure. Unfortunately, four things are obvious here. 1. The incredible cost estimate falls entirely upon the hospital. Mass [...]

I’m not quite sure what to make of that price quote. There is no doubt that the cost of circumcision for a 14-month-old would be much more expensive than for a newborn. Newborn circs are often performed right in the newborn nursery (no operating room expense) and there are no costs for anesthesia (newborns just [...]