Completing Healthcare Transactions at the Point-of-Service

Scott Shreeve in his Crossover Health blog raises the interesting issue of the need to complete healthcare transactions at the point-of-service (see: Millenial Patients: Care Delivery for the Next Generation of Patients). This goes to the question of how to modify healthcare transactions so that they more closely resemble the level of service offered in most other more consumer-oriented businesses. Here's an excerpt from his blog note with boldface emphasis mine:

In addition to getting comfortable discussing pricing, providers will need to be able to complete healthcare transactions at the point of service. As more consumers pay a higher percentage of their own healthcare costs (consumer payments are about $50 billion today), healthcare providers will need to adopt new technology and business processes. Failure to do so will result in an ever increasing uncollected payment burden... Part of this transformation includes eligibility verification, real-time co-pay/deductible accumulators, card/reader technology, and financial integration with consumer accounts. In addition, providers will need to become much more transparent with regard to pricing for their services. Retail clinics have led the way in posting cash prices, and physicians will need to learn to not penalize consumers with much higher cash prices. Rather, they’ll need to reward them for the real and tangible savings that cash payments make possible by avoiding the Byzantine insurance payment process. Companies like Recondo, TriHealix, and even practice management companies like athenahealth are leading the way.

To put the point bluntly, let's come to expect the same level of service from our healthcare providers that we expect from, say, the local grocery store or retail drug store or health club. For me, such expectations will include the following: (1) we should know the exact cost of medical services when we receive them; (2) we should be able to pay for such services when we order or receive them; (3) we should be rewarded in some way for long-term patronage of a business or provider; (4) we should expect a reasonable response when we judge medical services to be inadequate in some way; and (5) cash sales for services should not be penalized by higher prices and should actually be rewarded.

Ironically, direct access lab testing (DAT) is paid for at the time of the test order. The bad news is that these charges are generally not covered by most health insurance plans. The good news is that these DAT charges may sometimes be less than the co-payment amount for lab tests under some health insurance plans. Also, DAT web sites make their price lists readily available and thus make the cost of lab tests more transparent to consumers (see: DAT Makes Cost of Lab Testing More Transparent for Consumers).