Support our online development, and advance our onground research initiatives in free market economics, as we seek to showcase the brightest Next-Gen minds.
THE ME-P DISCLAIMER: Posts, comments and opinions do not necessarily represent iMBA, Inc., but become our property after submission. Copyright © 2006 to-date. iMBA, Inc allows colleges, universities, medical and financial professionals and related clinics, hospitals and non-profit healthcare organizations to distribute our proprietary essays, photos, videos, audios and other documents; etc. However, please review copyright and usage information for each individual asset before submission to us, and/or placement on your publication or web site. Attestation references, citations and/or back-links are required. All other assets are property of the individual copyright holder.
Providing Health Care in a High-Deductible World
By Steven Podnos MD, CFP®
With the increasingly common use of High Deductible Health Care Plans (HDHCP) (often combined with a Health Savings Account), health care providers are seeing a growing population of health care consumers that are paying “out of pocket” in some fashion for the first several thousand dollars of health care expenses each year.
Q: What is the impact of this for health care providers and hospitals?
Consider that historical pricing for health care services are much higher than providers expect to receive. Many “fee schedules” hark back to a day in which reimbursement bore some relationship to charged fees-almost unheard of now.
Let’s illustrate
Enter the consumer with a high deductible plan. Last year, with his old more traditional health insurance, he sees a physician for an initial visit. With ancillaries, the office bill might be $300, but the patient pays his $20 co-pay and leaves. The physician is contracted with the insurer to provide that level of service for a total of $110, and collect the remaining $90 from the carrier. Everybody is happy.
This year however, no one is happy. The consumer with the HDHCP gets a $300 bill for the same service that cost him $20 last year. He doesn’t know or doesn’t remember that his health care insurance premiums are lower than last year (as he may not pay them).
The result is one very unhappy patient. Clearly, health care providers need to adapt to the new world of HDHC plans. Hospitals and physician offices should have a list of charges for patients paying cash or having these plans. The charges would fairly approximate what they expect to receive from patients with Medicare and/or managed care plans for the same services.
Conversely, patients with these HDHC plans must learn to ask up front for a “cash” price on health care services.
Dr. Podnos is a fee-only financial planner in Brevard County, Florida.
Share this:
Filed under: Health Insurance | Tagged: High Deductible-HCPs | 9 Comments »
The Leading Business Education Network for Doctors, Financial Advisors and Health Industry Consultants 