Imagine that you could find competitive bids or quotes online to handle your non-emergency medical procedures, such as elective surgeries, just as you do with hotels or airfares. The concept may sound far-fetched, but websites such as Medibid and Pokitdok allow you to do just that.
These websites are filling an important niche in transparency of medical procedures. With high- deductible health plans (HDHPs) increasing as a part of the Affordable Care Act, people are responsible for more of their own healthcare costs and are thus more motivated to shop around for medical procedures.
Medical costs through a traditional hospital system include overhead elements that can be bypassed via cash payment, and patients that are responsible for most of their own healthcare costs are seeking cash payment options. However, getting a cash price for a procedure from a provider network can range from difficult to literally impossible.
Insurance companies and most healthcare providers have virtually no incentive to disclose the cost of a procedure. Even when you receive costs after the fact, it is difficult for most laymen to cut through the medical hieroglyphics and determine the true cost of a procedure. Costs can vary wildly within the same markets based on the deals negotiated between various provider networks and insurers, as well as local provider overhead.
Medical procedure shopping sites are designed to give patients the tools they need to make meaningful comparisons and intelligent cost decisions about their medical procedures. These new websites tend to fall into two categories: sites for pricing references that compile costs from various sources and geographical areas as a reference for negotiation (such as Healthcare Bluebook and Clear Health Costs), or sites that act as medical e-commerce sites connecting patients with area physicians through a competitive bid system or submission of quotes (such as Medibid, Pokitdok, and New Choice Health).
It may sound odd to travel halfway across the country to have a procedure done when local services are available, but that indicates how widely the cost structure varies. People have reported saving over half of the cost of multi-thousand dollar surgeries and minor procedures, even taking travel and lodging/recuperation costs into account.
If you decide to use a medical procedure shopping site, take the following things into consideration.
- Costs – To do a true cost comparison you need to consider both sides of the equation. With the traditional route, how much of your deductible is remaining and what are the out-of-pocket costs? You can get a general idea from the websites listed above, but verify where the cost information is coming from — Medicare reimbursements, average insurance payments, or actual costs submitted by healthcare providers.
- Insurance and Networks – Some sites will attempt to compare insurance with out-of-pocket costs by asking you to put in your insurance information, but agreements and networks are changing constantly. If you intend for insurance to pay for any of the procedure or for the costs to count against your deductible, we recommend verifying the site information with your insurance company before proceeding.
- Follow-up – Along with the freedom of negotiating your own price comes the responsibility of determining exactly what coverage is included, how follow-up care is to be handled, and what happens if something goes wrong. There are no eBay-like consumer protections with these websites; you are negotiating directly with the provider.
- Quality of Care – Sites may have some information about the healthcare provider’s record or history with a given procedure, but there is not much information on patient outcomes. It is highly unlikely that you will wake up in a bathtub full of ice in a remote motel room — but critics have a valid point by highlighting that you are on your own when it comes to verifying quality.
Take the time to research your provider, and if you do not feel comfortable with the proceedings, do not accept the bid. Cost savings do not matter when the outcome of the procedure is poor.
Medical shopping websites are on the cutting edge of healthcare cost-cutting innovation and just like any other cutting-edge development, enjoy the benefits but proceed with caution. Make sure that you understand all the ramifications before you agree to any procedure through these sites.