How radiologists can help price-conscious patients with high-deductible health plans
The rise of high-deductible health plans (HDHPs) has led to patients worrying more about the high prices associated with imaging services than ever before. According to a new study published in the Journal of the American College of Radiology, this often exposes those patients to inaccurate information.
“Unfortunately, patients who engage in such price shopping will frequently find not transparency but rather confusion, misinformation, and opaqueness,” wrote lead author David C. Levin, MD, department of radiology at Thomas Jefferson University Hospital in Philadelphia, Pennsylvania, and colleagues. “This poses a threat to some radiology practices, especially those that are hospital based.”
Several resources are available for patients wanting pricing information, but what can radiologists do to help ensure that information is accurate?
One potential strategy shared by Levin and colleagues is directing the patient to their actual health insurance provider “to get a precise indication of what he or she will owe, based upon what the insurer would pay if the deductible had already been met.”
“But one can well imagine the difficulty the patient might have in trying to get a real person on the line at some large insurance companies,” the authors wrote. “Even if the patient is able to get through, the company might not be willing or able to provide the information.”
Levin et al. also suggested imaging facilities could lower their prices to appear more competitive. When the Toledo Clinic in Ohio set their rates “well below those of other hospitals in the area,” it made competing providers upset, but did successfully give the clinic an advantage. Private imaging centers have also taken a similar approach in the past, advertising their discounted prices to attract price-conscious patients.
A third strategy, which the authors say may be the most effective, is perhaps the most simple: give patients that come to your facility accurate information about the true cost of their procedures.
“Software programs are available that allow this,” the authors wrote. “They work in the following manner: The centers create a list of all insurance plans with which they have contracts and enter it into the program. If a patient calls to inquire about costs for an imaging examination, the software first determines the patient’s eligibility with his or her health plan. After center personnel enter the patient’s name, plan identification number, and the CPT code of the examination requested, the software indicates what fee the center has negotiated with the health plan for that code, what the deductible is for that plan, how much has already been paid that year by the patient toward the deductible, and how much deductible still remains to be paid.”
Facility employees can use that software to provide patients with fairly accurate information, though it still may not be 100 percent correct. This approach, however, may not always work for hospitals due to confidentiality concerns.
Michael has more than 18 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.