Response to Discussion post

Need help with my Health & Medical question – I’m studying for my class.

Maria Lopez-Gonzalez posted Feb 19, 2020



1. It is the responsibility of hospitals, insurance companies, and anyone offering services to patients, to disclose pricing. For years hospitals were not required to place prices online. However, the current president has now made it a requirement for hospitals to be transparent with their pricing. In an article titled, “Trump releases rule forcing hospitals and insurers to disclose negotiated rates or face fines,” Lovelace explains that hospitals and insurers have been criticized for keeping their negotiated rates a secret and that is why having this new initiative is important. Lovelace also explains that this new change will force companies to disclose rates in order to empower patients to find lower-priced alternatives. Failure to comply with this new rule will cost a hospital $300 a day for noncompliance. I agree with the initiative because a patient should have the right to know what they are paying for and be able to compare prices in order to get the treatment they need at an affordable price. A patient should not have to worry about a surprisingly high bill, they should be able to know what to expect.

Reference:

Lovelace, B. (2019, November 15). Trump releases rule forcing hospitals and insurers to disclose negotiated rates or face fines. Retrieved February 19, 2020, from https://www.cnbc.com/2019/11/15/trump-releases-rule-requiring-hospitals-and-insurers-to-disclose-negotiated-rates.html

Crystal Cutsinger posted Feb 19, 2020 10:44 PM



2.Who’s responsibility is it to communicate pricing to patients (hospitals, government, insurance companies, physicians, others)?

In my personal opinion I believe all should communicate pricing to the patient. Given that we are in an increasing economy where everyone wants something for less. I believe we should be able to determine for ourselves where to go based on pricing and coverage options. There are many cases where pricing should be brought up by a doctor but also with and insurance company to make sure your receiving the best care for your money.

According to healthcare.gov, “In order to pick a plan based on your total costs of care, you’ll need to estimate the medical services you’ll use for the year ahead. Of course it’s impossible to predict the exact amount. So think about how much care you usually use, or are likely to use.” (2020) they have a price and plan preview site that should help you estimate your coverages to reduce unexpected costs.

Reference

How to pick a health insurance plan. 2020 retrieved from: https://www.healthcare.gov/choose-a-plan/your-total-costs/

Wen Chen posted Feb 19, 2020 10:16 PM



3.Physicians have responsibility to patients to communicate the cost of care, prescriptions. Patients want their doctors to make critical health care decisions and provide them with the best quality care, but they also increasingly want to be able to find out from their providers how much that care will cost. Without price information or a culture that enables explicit exploration of financial factors, consumers have limited ability to make good decisions about how best to meet both their clinical and financial needs.

Pathologists, surgeons and anesthesiologists should tell patients about the types of providers who typically participate in a service. Patients should be informed that actual costs may vary from estimates depending on services actually performed, whether the provider performing the service is in or out of network with the patient’s insurance company, and timing issues related to other payments that could affect their deductibles. Patient share discussions shouldn’t interfere with care and should focus on patient education.

While 76 percent of patients surveyed by Avalere Health felt it was important to discuss the costs of their care with their physician, 21 percent said they received some, little, or no such information during a doctor visit. Physicians should not make assumptions about which patients may want to have financial discussions. Primary care doctors can also refer patients to pharmaceutical companies’ financial assistance programs or use apps such as GoodRx, which can sometimes provide discounts on prescription drugs. While some medical treatments and diagnostic tests are unavoidable, others can be spread out to help with budgeting. This may give the patients the option to choose between different treatment pathways, or delay a test or procedure the patient ultimately decides is not worth the cost.

References:

Gordon, Deb. (September 16,2019). Physicians have responsibility to patients to talk about the cost of care, prescriptions.

Retrieved from: https://www.usatoday.com/story/opinion/2018/12/03/doctors-providers-provide-patients-treatment-cost-information-health-care-column/2077749002/

Aldrich. (April 4,2016). How to Communicate Financial Information to Patients. Retrieved from: https://aldrichadvisors.com/healthcare/patient-financial-communication/

Kaplan, Deborah. (July 1, 2019). Discussing costs of care with patients. Retrieved from: https://www.medicaleconomics.com/news/discussing-costs-care-patients





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