Why Price Transparency Is Essential in the Health Care Industry

Because prices in the medical industry are typically hidden from the consumer, there are large price disparities between different providers and in different parts of the country. But new regulations requiring greater price transparency are coming and will benefit all healthcare consumers.

Price Disparities in the Health Care Industry

Let’s talk numbers to get a real look at the gap. Take, for instance, the standard CBC blood test, which is one of the most common tests performed in the US. In Miami, the price for these tests ranges anywhere from $149 to $725—a significant difference considering the test is being performed in the same city. San Francisco ranges from $80 to $564.

Sadly, most Americans aren’t aware of there being such a significant difference. In fact, most Americans aren’t aware of the costs of their treatment at all because doctors and hospitals tend to keep their prices hidden.

Increasing Price Transparency

Starting this year (2019), hospitals are now required to post prices for procedures online. This move will hopefully help educate consumers when making healthcare decisions. However, it’s not as straightforward as it sounds.

The list price typically isn’t what you end up paying. The actual cost comes from the hospitals and insurance companies negotiating, and of course, those prices are not listed. So, the amount you end up paying depends on the overall negotiation, as well as their insurance, co-pays, and deductibles.

How to Wade Through Such Huge Price Gaps

1. Do your research. For non-emergency treatment, ask your provider what they are going to charge. Compare this to what you see elsewhere. Use tools such as Healthcare Blue Book, or New Choice Health to look up average pricing.

2. Ask for the cash price. Often, labs or doctors will offer discounts for patients who pay cash up front. That way, they don’t have to deal with the insurance company, and it’s immediate payment.

3. Shop around. Don’t settle for the closest lab or doctor. A few minutes online and on the phone may save you a bundle. When you do pick, make sure the doctor or lab is within your network if you have insurance.

4. Negotiate your bill. Always check your bill to make sure it’s correct first, and then negotiate with the doctor or lab for the cost of the procedure. Better yet, get a bill negotiation company to negotiate on your behalf—HSA for America partnered with South Florida Utilization Review (SFUR) to help you lower your medical bills. Learn more about it here.

Secrecy is the main driving force behind such significant price discrepancies. Fully and openly divulging these prices would go a long way in helping bring the costs down and closing the gap. Until then, be smart and do your research.

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To your health and wealth,

Wiley P. Long, III
President - HSA for America

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