What if the procedure is not typical and the patient has a complication? Case-by-case supplemental insurance exists and is often bundled into the procedure package. However, in the unfortunate event that you require hospitalization, you’ll exceed your deductible and your out-of-pocket expenses will be capped anyway.
Cosmetic plastic surgeons have been providing all-inclusive surgical packages for years. It’s not only a viable option for cosmetics. This facility, a member of the Free Market Medical Association, bundles the pricing for their spine care surgery center. And they’re not the only one.
I recognize that insurance companies and providers have negotiated rates. But I also know that providers, including hospitals and outpatient facilities have “prompt pay” discounts or cash-pay prices that are often less than the negotiated rates. Somewhere along the way, we’ve been led to believe that the negotiated rate is synonymous with the least expensive rate. A negotiated rate may be less than an out-of-network insurance rate, but it’s far from the least expensive rate.
Remember, the consumer with a high-deductible health plan, which makes up more than 50% of employer-provided health insurance plans now (Kaiser Family Foundation), are paying this money out of pocket regardless. So better to pay out a lesser amount toward a discounted bundled pricing package than the out-of-pocket negotiated rate. And whatever the consumer spends, whether it’s in network or out, can still apply to their deductible.
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Simply put, we’re focusing on the wrong thing here. Why crunch big data to only assist the consumer in paying too much for their out-of-pocket healthcare expenses? Let’s give them the actionable pricing information they need by encouraging providers to embrace and show the bundled pricing policies they already have in place.