Medical students trained in discussing cost of care
September 14, 2015
At DocSpot, our mission is to connect people with the right health care by helping them navigate publicly available information. We believe the first step of that mission is to help connect people with an appropriate medical provider, and we look forward to helping people navigate other aspects of their care as the opportunities arise. We are just at the start of that mission, so we hope you will come back often to see how things are developing.
An underlying philosophy of our work is that right care means different things to different people. We also recognize that doctors are multidimensional people. So, instead of trying to determine which doctors are "better" than others, we offer a variety of filter options that individuals can apply to more quickly discover providers that fit their needs.
September 14, 2015
The cost of medical care is increasingly becoming a concern for many Americans. This is especially true in light of higher deductibles and higher co-pays. Interestingly, this trend is strong enough that the provider community is taking notice. NPR reports that most of the surveyed medical schools that responded indicated that they offer a required course about the cost of medical care. The article cites the Affordable Care Act as the reason, as it moves the medical community towards high-value care, not simply rewarding doctors for volume.
As providers engage with patients more and more about cost, patients themselves will increasingly start thinking about higher value care. As time goes on, maybe we'll start to see a bend in the so-called cost curve.
September 07, 2015
A number of health insurers have lost money on their offerings sold through the health insurance exchanges. As The Wall Street Journal reports, some of these insurers are paring back their offerings or limiting consumer access to more costly providers. In general, this probably makes sense because the Affordable Care Act did little to address the healthcare costs directly, but did put pressure on premiums by making it easy to compare offerings across different insurers. So, if consumers still had access to the same expensive providers, and many sicker-than-average consumers who were previously unable to get medical coverage now access those providers, it's not surprising that health insurers fared worse than planned. It's also not surprising that insurers are trying to figure out how to limit their costs. An obvious way would be to limit access to the most expensive providers. Unfortunately, those providers might be the same ones that are often thought of as the best providers, even if there is little correlation between cost and quality in healthcare.
It might take consumers a few cycles, but eventually they'll understand that not all plans in the same tier offer the same benefits. When that happens, I expect that there will be more distinct segmentation of the offerings. For example, there might be a higher-cost insurance plan that offers access to a broader physician network, and a lower-cost plan that offers access to a narrower network. Hopefully, over time, there will also be more sophisticated tools to help consumers evaluate plans on these non-financial criteria. In the meantime, we should brace ourselves for some surprises about patients expecting specific doctors to accept their plan when that is not the case.
August 30, 2015
Earlier, we noted that states like Oregon were requiring that insurance companies raise their premiums. Kaiser Health News reported that the Department of Health and Human Services (HHS, part of the federal government) is pushing for lower insurance premiums. The conflicting directions probably stem from different emphases on time frames from different departments.
State insurance regulators have a longer-term fear that insurance companies who set their premiums too low will go out of business, leaving the state exchanges short on viable options. HHS, on the other hand, probably wants to cement some goodwill in the general population, especially before the 2016 elections. Part of the issue is that insurance premiums for many Americans increased when ACA rolled out (my personal premiums basically doubled). The recent media about insurance companies requesting 20% or 30% annual increases (on top of earlier increases) certainly gives additional ammunition to ACA's critics. Understandably, HHS would want to minimize these increases, perhaps arguing that a short-term outcome that is favorably received by the general population is necessary for the long-term success of the law. It'll be interesting to see where premiums settle over the next few years, and whether or not those increases are above or below the annual premium growth of the decade before ACA.
August 22, 2015
The Kaiser Family Foundation released the results to an interesting survey this week. About three-quarters of the people polled felt that the cost of prescription drugs are unreasonably high. The cost of prescription drugs ranks above doctor visits as a financial burden (though less than health premiums and deductibles). 74% of those surveyed answered that they believe pharmaceutical companies are too concerned about making profits, as opposed to having the right balance between profits and helping people. Perhaps, then, we shouldn't be surprised that pharmaceutical companies had the largest percentage of respondents who had a very unfavorable view of them -- even more than oil companies.
Interestingly, while 78% of those surveyed think that generic prescription drugs are of the same quality as brand-name prescription drugs, only 52% asked for a generic drug when prescribed a brand-name drug. Perhaps a significant sector of those surveyed did not know they could ask for a generic version, or maybe they don't actually think that the cost of prescription drugs is unreasonably high. Respondents seem open to a variety of mechanism to address prescription drug costs, including allowing Americans to import drugs from Canada.
August 15, 2015
Earlier, we had noted how the state of Massachusetts requires that health care providers make pricing information available to inquiring consumers. It appears that the legislation did not specify any consequences, and perhaps not surprisingly, people are still having difficulty procuring pricing information. Interestingly, the difficulty differed by specialty.
The president of the Massachusetts Medical Society seems to defend doctors' offices by saying that prices are complicated because different insurers have negotiated different rates. The problem with that line? Doctors' offices didn't even know the price that would be charged to patients who would pay without insurance.
Sadly, the health insurance companies also fared poorly in a review of their tools for online healthcare shopping. Still, the legislation is a step in the right direction, and hopefully, more of the industry will adjust as increasing numbers of patients ask for this information.