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Massachusetts recently became the first state in the country to require disclosure of pricing upon request from patients. Patients, for the first time, can shop around for the best price on tests, procedures and office visits.
The law went into effect in October and insurance companies doing business in Massachusetts are required to disclose pricing information within two working days of a patient’s request. Starting October 2014 the prices have to be available immediately. Physicians are required to start disclosing prices by January 1, 2014.
According to the Boston Globe, “Backers believe transparency will lead to lower prices as providers compete with one another and consumers shop around. So far, health insurers, hospitals, and doctors have been slow to spread the word about the initiatives, fearing patients will inundate them with requests for estimates before they are fully ready.”
But the requests have been sparse to date. Three large carriers in the state, Blue Cross & Blue Shield, Tufts Medical and Harvard Pilgrim reported a total of 234 inquiries in the first two months.
One Boston hospital, Beth Israel Deaconess Medical Center, has been providing patients with estimates in a pilot program since May in the interest of full disclosure, often without a patient request. Harvard Pilgrim has developed a website where patients can comparison shop the same procedure at different locations.
At the other end of the spectrum, while Blue Cross & Blue Shield is complying with the law they are requiring that patients provide them with codes for the various tests and procedures, an obstacle that could be difficult for patients since there are literally thousands of codes. They will need to get them from their physicians before calling their insurers.
Physicians will undoubtedly face more phone calls and more office work from patients looking to price procedures such as MRIs and other services. What do you think the impact will be on medical offices? Is price shopping and “patient transparency” ultimately a good thing? If you’re an M.D. or D.O. we will be continuing the conversation inside the Sermo Community, join us.
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