Review: "Patients Want To Price-Shop For Care, But Online Tools Unreliable" – NPR

This was another fantastic article from NPR today, written by Elana Gordon.


In this article, real Americans with real jobs and real health concerns discuss how difficult it is to find out what things cost when they finally needed to access the health care system. The couple in the story began to use an "online cost estimator offered through their insurance company." I find it sad that first-off, the insurance companies have to "estimate" anything; since they have a chargemaster. They know what they will reimburse for various things.


"At first, this kind of information seemed great to the couple. But it quickly proved to be quite the headache."


This should come as no surprise since the system is set up to be willfully convoluted and frustrating. Insurance companies, not surprisingly, have no incentives to actually create an estimator that is definitive. And companies who provide the services have disincentives to actually post their prices because they fear the competition.


"That gets at a deeper challenge with these online estimators...The way billing and reimbursement works in health care is extremely complicated...there are 8,000 procedure codes, tens of thousands of diagnostic codes, a million different providers, and hundreds of insurance companies."


How could we possibly make sense of this mayhem? P.S.Y.C.H. does this easily. By setting the state price lists, we know exactly what things costs, what will be reimbursed (preventative and some portions of sick visits), and what to code. We eliminate the need for "hundreds of insurance companies" that won't want to stay in the health care business when they're not making millions in profit.


We have to stop and ask ourselves, why are we paying a private company to take money out of the health care system (to pay their staff and shareholders) when that money can go directly to providers, back in patients' pockets, and decrease business costs thereby boosting economic growth and output?


I think that once any person sits and thinks through the P.S.Y.C.H. plan, it just makes inherent sense.

#onlinehealthtools #billing #reimbursement #chargemaster #pricelist #NPR

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