Many employers are now providing high deductible heath plans (HDHP) to their employees with lower monthly cost to the companies but with a catch -- the employees need to pay more of the healthcare costs themselves (i.e., the deductible) before the insurance company covers anything. HDHPs have begun to stimulate consumers to shop for lower priced healthcare services. The Dark Daily recently discussed bundled pricing which provides the opportunity for consumers to save money on healthcare (see: More Providers and Payers Use Bundled Pricing to Serve Patients with High Deductibles in a Trend That Has Financial Implications for Clinical Laboratories). Below are some of the details from the article:
With so many people seeking more economical choices for their healthcare needs, providers, hospitals, and health insurers are exploring the options bundled pricing offers. One new twist in the healthcare marketplace is a type of company that specializes in negotiating bundled healthcare options that service the self-pay market. These companies make their offerings available to patients through websites designed specifically to be searched by patients who want to select healthcare providers based on cost and performance. One example of this new type of company is MDSave....Launched in 2012..., the MDSave website offers patients discounts of as much as 60% on medical care, including office visits, surgeries, and X-rays. The self-proclaimed “world’s first healthcare marketplace” does this by collaborating with hospital groups and ambulatory surgical centers to negotiate discounted rates for various services with hospitals and doctors. It then packages those services into a single bundle. On their website, patients can shop for hundreds of procedures, including elective surgeries and routine care. Users also can read reviews and compare pricing for local providers before selecting their best option. Patients then pay up front for needed services, with all fees combined into one bundled price. When a purchase is made through MDSave, the chosen doctor’s office is notified and the patient is contacted to schedule an appointment. The bundled price includes all costs for medical personnel, the facility, and any related services, ensuring there will be no additional medical bills for the patient.that is paid by patients. It may mean negotiating their share of the bundled payment in competition with the hospitals, physicians, radiology labs, and other providers that are part of that same bundled service.
The MDSave web site makes clear the advantage of bundled pricing (see quote below). In case you were wondering, the amount spent obtaining care from an MDSave providers is usually applied to the health insurance deductible but insurance companies will have different eligibility requirements.
An MRI, for example, can include an imaging fee, a radiologist’s fee to read the images, and the hospital’s facility fee. By bundling these costs, MDsave eliminates the multiple bills patients may receive for each fee. In addition, through our relationships with trusted hospitals and doctors, we are able to offer discounted rates, with savings up to 60%.
It occurred to me that some large percentage of consumers who choose HDHPs might not be able to afford the up-front payment required by MDSave. After all, many choose such plans to reduce the monthly cost for health insurance. The company has a solution for this which is described in the following way on the web site (Patient Financing):
MDsave has partnered with Prosper to help patients purchase out-of-pocket expenses associated with procedures. We provide access to simple interest installment loans to ease the financial burden of medical expenses. Prosper offers access to low monthly payments on loans for all MDSave procedures for amounts between $2,000 and $35,000. After receiving funds, call MDsave to get your procedure voucher.
The choice of providers seems to be quite limited at the MDSave web site currently. To seek a "flu shot, colonoscopy, CT scan" (one heterogeneous category offered by the web site), I was directed to a medical center in a small town in Ohio 178 miles from my home. I suspect that prestigious hospitals and clinics will not want to participate in this bundled payment system at the present time but this may change in the future as the competition heats up (see: Anthem Blue Cross of California pilots bundled payments on breast cancer treatment).