“Transparency in Pricing by Healthcare Providers”
Doctors’ Take on Breaking Healthcare News
President Trump issued an executive order on 6/24/19 designed to pressure insurance companies, hospitals and doctors to disclose more information about their prices. The order directs the Department of Health and Human Services to have all providers and insurers disclose their negotiated rates for services and provide patients with out-of-pocket expenses (expected patient responsibility) before services are provided.
Doctors’ Take
Because the number one concern of Americans is escalating healthcare cost, according to recent Gallup and other polls, and political debates about healthcare before the Presidential Election, it’s unclear what the Oval Office and Congress will actually do to protect the public from excessive costs. The President may finally want to show Americans he “cares” about medical costs that continue to be the #1 cause for personal bankruptcy. He may be anticipating criticism emanating from the Democratic presidential candidates.
We (Drs. Lazarus and Foster) strongly recommend that you request all financial information from doctors and facilities before undergoing diagnostic and medical treatment. Please refer to Chapter 2, Strategies for keeping Costs Down, in our newly published Insider’s Guide to Quality, Affordable Healthcare, available from Amazon and bookstores nationwide.
Congress May Pass a Bill Banning (or Reducing) Surprise Billing
Thirty-eight percent of Americans are “very worried” about unexpected (surprise) bills. Surprise bills occur when a patient is seen by a doctor in the Emergency Department or receives services when hospitalized from out-of-network providers. The bipartisan Lower Health Care Costs Act of 2019 would protect patients from surprise bills and increase transparency for patients and employers to understand what they’re paying for. Bipartisan passage into law may occur before Congress’ summer recess.
Doctors’ Take
Many states already have laws to protect patients, such as requiring providers, insurers and patients to arbitrate (compromise) surprise bills. We suggest:
- Make certain all your providers are in-network.
- Find out what part of your healthcare services will be paid by your primary insurance and, if you have a secondary insurance, what will be your cost. Do this before receiving care.
- You, and perhaps with the help of a knowledgeable family member, may be able to negotiate a reduction or have a specialized billing service negotiate on your behalf.
Please share your experiences, and ask the doctors questions via www.qualityaffordablehealthcare.net.
Best regards,
Dr. Larry Lazarus; Dr. Jeff Foster