6 ms·

I just learned, to my surprise, that pricing and transparency changes may go into effect next year. Forcing hospitals to disclose prices: https://www.nytimes.

by Reedx 7y ago

I just learned, to my surprise, that pricing and transparency changes may go into effect next year. Forcing hospitals to disclose prices: https://www.nytimes.com/2019/11/15/health/list-hospital-prices-trump.html https://www.nytimes.com/2019/11/15/health/list-hospital-pric... Though the hospital industry is fighting it, so we'll have to see if the rule survives.

ceejayoz 7y ago
I'm completely onboard with price transparency, but am skeptical as to the utility of it to the consumer. I suspect a lot of people will get "oh, we thought it'd be X, but it turned out to be Y, which is 3x the price" sort of scenarios. I'm sure "colonoscopy, clear" and "colonoscopy, with removal of polyp and pathology on it" will have different prices, but you won't know which it is until after the procedure.
- dsfyu404ed 7y ago
  >I'm sure "colonoscopy, clear" and "colonoscopy, with removal of polyp and pathology on it" will have different prices, but you won't know which it is until after the procedure. Considering that colonoscopies are not urgent you'll likely elect to have your butt probed at the clinic that doesn't have a massive price discrepancy between removing something and not. I really hope the price transparency rule works as alleged. I'd be totally unsurprising if the entrenched industry finds some way to neuter it but I'm hopeful.
  - ivalm 7y ago
    > Considering that colonoscopies are not urgent you'll likely elect to have your butt probed at the clinic that doesn't have a massive price discrepancy between removing something and not. For most people they have insurance and for them to get any kind of help paying they need to be working with an in-network provider. There is no meaningful market here even for elective/non-acute procedures.
- SkyPuncher 7y ago
  Some how automotive repair, general contracting, and many other industries have been able to solve this problem. It's baffling how medicine can't produce accurate estimates. Sure, there are edge cases and differences between patients. However, every surgeon has a rough idea of how they're planning to do a procedure. They've been trained and practiced on it many, many times. I have a torn meniscus. The doctor can happily tell me how easy it is to clean up and exactly what he'll do to fix it. He certainly knows what the risks are and potential complications. Why he can't document that prior to surgery, I have no clue.
  - xylophone 7y ago
    I agree. I would say the only reason providers are not cost estimating is because they don't need to in order to get business. For automotive I'm typically getting a problem diagnosed first, then after diagnosis, I'm agreeing to a price for a fix. This is the norm for that industry. For a walk in appointment for a rash, I'm agreeing to a fixed visit fee, PLUS signing that I agree to pay any charges my insurance does not agree to pay. The true costs can (and should) be computed by the provider, so the only true unknown in that equation is what Insurance will cover. THEN the provider (wanting to cover their bases) is putting that risk of not getting paid by insurance, back onto the patient. I like to think we're 1 killer app away from a shift in consumer behavior here to change the expectations
    - pkaye 7y ago
      I'm in the Kaiser Permanente system in California where the hospital and insurance are one entity. Since everything is pre-negotiated, most times its just the copay. So under my plan, for example $20 for primary physician visit, $40 for specialist visit, $20 for blood test visit and $100 for emergency visit. Having one entity involved simplifies things.
      - pblcprvscrt 7y ago
        Kaiser utilizes the Experian program.
  - 7y ago
- unishark 7y ago
  The pricing game in the medical field is not that though, it's just a ridiculous tradition. They give hugely inflated prices then accept a fraction of that from insurance companies because it was their real price anyway. If any uninsured individual (e.g. with good credit they want to protect) gets ensnared by this and ends up paying their 3x number it's totally unfair. when they are selling similar procedures for elective or cosmetic surgery, like plastic surgery patients, the prices they ask are much more competitive.
  - albeebe1 7y ago
    i wonder if they inflate the prices to inflate their write offs come tax time.
    - pkaye 7y ago
      No they can only write off actual costs.
      - Gibbon1 7y ago
        I'm pretty sure a good accountant can drive semi-truck full of large bills through that.
      - devonkim 7y ago
        I dunno, the reality is that we have mark to market accounting https://en.m.wikipedia.org/wiki/Mark-to-market_accounting https://en.m.wikipedia.org/wiki/Mark-to-market_accounting
- gshulegaard 7y ago
  While I understand your healthy skepticism, I would be a bit more bullish given this example from 2013: https://kfor.com/news/okc-hospital-posting-surgery-prices-online/ https://kfor.com/news/okc-hospital-posting-surgery-prices-on... One thing is for sure, any improvement to price transparency is a boon to competition.
  - therealdrag0 7y ago
    Thought provoking chat with owner: https://www.econtalk.org/keith-smith-on-free-market-health-care/ https://www.econtalk.org/keith-smith-on-free-market-health-c...
  - ceejayoz 7y ago
    > Some Hospital administrators accuse the surgery center of cherry-picking the healthiest and wealthiest patients. You probably won’t see this place put a fixed cost on a 26 week preemie like my twins.
- thiagomgd 7y ago
  > I'm sure "colonoscopy, clear" and "colonoscopy, with removal of polyp and pathology on it" will have different prices, but you won't know which it is until after the procedure. Which is expected, and kinda ok. At least, if you do a colonoscopy and there's nothing else, no complications, it would be that price.
- TYPE_FASTER 7y ago
  > am skeptical as to the utility of it to the consumer. Yeah, me too. It definitely seems like more of a way to look like the industry is doing something without actually reducing costs to the end patient. Our daughter went to the ER and was administered ibuprofen. We got an itemized invoice. Insurance paid $9 for one pill. So going forward, I guess I'll be able to ask how much the pill will cost, then...haggle? Tell them not to give my daughter medicine? Just seems like we're going backward...

by Reedx 7y ago

ceejayoz 7y ago

I'm completely onboard with price transparency, but am skeptical as to the utility of it to the consumer. I suspect a lot of people will get "oh, we thought it'd be X, but it turned out to be Y, which is 3x the price" sort of scenarios. I'm sure "colonoscopy, clear" and "colonoscopy, with removal of polyp and pathology on it" will have different prices, but you won't know which it is until after the procedure.

dsfyu404ed 7y ago
>I'm sure "colonoscopy, clear" and "colonoscopy, with removal of polyp and pathology on it" will have different prices, but you won't know which it is until after the procedure. Considering that colonoscopies are not urgent you'll likely elect to have your butt probed at the clinic that doesn't have a massive price discrepancy between removing something and not. I really hope the price transparency rule works as alleged. I'd be totally unsurprising if the entrenched industry finds some way to neuter it but I'm hopeful.
- ivalm 7y ago
  > Considering that colonoscopies are not urgent you'll likely elect to have your butt probed at the clinic that doesn't have a massive price discrepancy between removing something and not. For most people they have insurance and for them to get any kind of help paying they need to be working with an in-network provider. There is no meaningful market here even for elective/non-acute procedures.
SkyPuncher 7y ago
Some how automotive repair, general contracting, and many other industries have been able to solve this problem. It's baffling how medicine can't produce accurate estimates. Sure, there are edge cases and differences between patients. However, every surgeon has a rough idea of how they're planning to do a procedure. They've been trained and practiced on it many, many times. I have a torn meniscus. The doctor can happily tell me how easy it is to clean up and exactly what he'll do to fix it. He certainly knows what the risks are and potential complications. Why he can't document that prior to surgery, I have no clue.
- xylophone 7y ago
  I agree. I would say the only reason providers are not cost estimating is because they don't need to in order to get business. For automotive I'm typically getting a problem diagnosed first, then after diagnosis, I'm agreeing to a price for a fix. This is the norm for that industry. For a walk in appointment for a rash, I'm agreeing to a fixed visit fee, PLUS signing that I agree to pay any charges my insurance does not agree to pay. The true costs can (and should) be computed by the provider, so the only true unknown in that equation is what Insurance will cover. THEN the provider (wanting to cover their bases) is putting that risk of not getting paid by insurance, back onto the patient. I like to think we're 1 killer app away from a shift in consumer behavior here to change the expectations
  - pkaye 7y ago
    I'm in the Kaiser Permanente system in California where the hospital and insurance are one entity. Since everything is pre-negotiated, most times its just the copay. So under my plan, for example $20 for primary physician visit, $40 for specialist visit, $20 for blood test visit and $100 for emergency visit. Having one entity involved simplifies things.
    - pblcprvscrt 7y ago
      Kaiser utilizes the Experian program.
- 7y ago
unishark 7y ago
The pricing game in the medical field is not that though, it's just a ridiculous tradition. They give hugely inflated prices then accept a fraction of that from insurance companies because it was their real price anyway. If any uninsured individual (e.g. with good credit they want to protect) gets ensnared by this and ends up paying their 3x number it's totally unfair. when they are selling similar procedures for elective or cosmetic surgery, like plastic surgery patients, the prices they ask are much more competitive.
- albeebe1 7y ago
  i wonder if they inflate the prices to inflate their write offs come tax time.
  - pkaye 7y ago
    No they can only write off actual costs.
    - Gibbon1 7y ago
      I'm pretty sure a good accountant can drive semi-truck full of large bills through that.
    - devonkim 7y ago
      I dunno, the reality is that we have mark to market accounting https://en.m.wikipedia.org/wiki/Mark-to-market_accounting https://en.m.wikipedia.org/wiki/Mark-to-market_accounting
gshulegaard 7y ago
While I understand your healthy skepticism, I would be a bit more bullish given this example from 2013: https://kfor.com/news/okc-hospital-posting-surgery-prices-online/ https://kfor.com/news/okc-hospital-posting-surgery-prices-on... One thing is for sure, any improvement to price transparency is a boon to competition.
- therealdrag0 7y ago
  Thought provoking chat with owner: https://www.econtalk.org/keith-smith-on-free-market-health-care/ https://www.econtalk.org/keith-smith-on-free-market-health-c...
- ceejayoz 7y ago
  > Some Hospital administrators accuse the surgery center of cherry-picking the healthiest and wealthiest patients. You probably won’t see this place put a fixed cost on a 26 week preemie like my twins.
thiagomgd 7y ago
> I'm sure "colonoscopy, clear" and "colonoscopy, with removal of polyp and pathology on it" will have different prices, but you won't know which it is until after the procedure. Which is expected, and kinda ok. At least, if you do a colonoscopy and there's nothing else, no complications, it would be that price.
TYPE_FASTER 7y ago
> am skeptical as to the utility of it to the consumer. Yeah, me too. It definitely seems like more of a way to look like the industry is doing something without actually reducing costs to the end patient. Our daughter went to the ER and was administered ibuprofen. We got an itemized invoice. Insurance paid $9 for one pill. So going forward, I guess I'll be able to ask how much the pill will cost, then...haggle? Tell them not to give my daughter medicine? Just seems like we're going backward...