4 ms·

There are a few relatively commodity items you have mentioned, flu shots for one, mammogram possibly another, but for > 65% of patients those are already cover

There are a few relatively commodity items you have mentioned, flu shots for one, mammogram possibly another, but for > 65% of patients those are already covered at extremely low/no cost. Yes, there is room to help the remaining 35%. As you get into xray, clinical laboratory, other imaging things become very complicated where the order from the provider is commonly bound to a particular facility. Trying to get a provider to write an MRI order to a facility they have not worked with before is often a multi-day process fraught with error due to complexity in the order itself. Most patients cannot get their providers office in active communication long enough to even try it. For procedures there is an exponential explosion in complexity. Electives are really, really complex. A birth or a hip replacement is not the same thing across facilities so how do you compare code level pricing? With drugs GoodRX has produced excellent results for patients. I think that works so well because overwhelmingly drugs are commodity goods. I do see an oppourtunity because health systems spend a tremendous amount on patient acquisition currently but I am having a difficult time seeing the dots connect into pricing decisions by patients.

kunle 4y ago
So your point on items covered by insurers is right with the caveat that way more patients are now on high deductible plans, so your out of pocket cost still gets impacted by the contract rates even if the provider is in network. Agree on electives - there’s something to do there price wise but it’s not the most straightforward. Re: pricing in general, it def matters in the decision but how you present it makes a huge difference. For uninsured people our flu map has actually been super critical (people are more likely to choose an option with a price at all and marginally more likely to choose a lower priced option (the price spreads are lower bc it’s a simple procedure but there are some places where you can pay over $100 for a flu shot - no one chooses those once they know) The nit here is you have to give a person the ability to a) select their insurance, and b) show them the full out of pocket cost (copay + deductible) and then it makes a difference, which favors a logged in experience (like solv or Zocdoc) over a logged out experience. But I’m convinced that the reason it’s hard to see today is not because people don’t care about price. It’s because they don’t get to price discriminate at all.

kunle 4y ago

So your point on items covered by insurers is right with the caveat that way more patients are now on high deductible plans, so your out of pocket cost still gets impacted by the contract rates even if the provider is in network. Agree on electives - there’s something to do there price wise but it’s not the most straightforward. Re: pricing in general, it def matters in the decision but how you present it makes a huge difference. For uninsured people our flu map has actually been super critical (people are more likely to choose an option with a price at all and marginally more likely to choose a lower priced option (the price spreads are lower bc it’s a simple procedure but there are some places where you can pay over $100 for a flu shot - no one chooses those once they know) The nit here is you have to give a person the ability to a) select their insurance, and b) show them the full out of pocket cost (copay + deductible) and then it makes a difference, which favors a logged in experience (like solv or Zocdoc) over a logged out experience. But I’m convinced that the reason it’s hard to see today is not because people don’t care about price. It’s because they don’t get to price discriminate at all.