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Transparency in Health Care Costs

There has been a lot written lately about the upcoming transparency in Health Care costs. Soon there will be a number of web pages that will be posting the charges of hospitals and doctors offices for routine visits and procedures. The goal is to allow the public to educate themselves on what things really do cost before they make decisions on where they are getting their healthcare services performed. There has been investigation into the very wide span of what people have for coverage and what various providers are paid by the Massachusetts Attorney General. To those of us who work in healthcare, it isn’t a surprise to find out that the major hospitals are paid much more than smaller hospitals and private clinics for the same exact services. Currently, there is no plan to publish this information…and until this happens consumers still can’t make an educated choice about how to spend their money.
In order to be an in-network provider for an insurance company, we have to agree on a contract for reimbursement. As a small private practice in a market that is saturated with businesses that provide similar services, we have very little power for negotiation (and by little, I actually mean none)…the big hospitals hold all the clout and use it to get paid multiple times more than we do. Is it fair? I know it’s not fair to those patients with a deductible…because you have to pay for what is acceptable via the providers contract you pay more for “the same” services…not fair.
In order to really control your own health care costs, try to use local, small providers that don’t have the ability to negotiate huge contracts from your insurance company…pay less…and most likely for better services.

Michael Vacon, PT
Managing Partner