Price Transparency in the Medical Field

In the latest episode of the Futurum Tech Podcast, The Interview Series, Daniel Newman welcomes Dr. George Mathew, who is an internal medicine physician and Chief Medical Officer for the Americas for DXC Technology. He also welcomes Paul Thompson, Vice President of Global Healthcare Strategy and Product Development for DXC Technology. In this podcast episode, the two talked to Dan about the current state of price transparency in the medical field—and how technology can improve this issue.

 

First, they agreed on the fact that most patients don’t think about what the real cost of a procedure or office visit is. They think about their copay, not what insurers are charged, meaning they’re insulated from the true cost of healthcare. Dan mentioned that people want to know more, kind of, but mostly they want to pay less!

 

Currently, healthcare is about people paying insurance premiums and copays and then not worrying about it. But lately, large employers are pushing larger insurance costs onto their employees, and it’s becoming a problem that people are more worried about. They’re starting to demand price transparency, which starts with better communication of what services are being rendered, and what people are paying for.

 

When Dan asked how providers are addressing transparency in healthcare today, and how technology can help this, George replied with his experience working with commercial health plans. At that time, the work was focused on increasing the efficiency of providers, information that was delivered through an online provider directory that allowed them to share a lot of information. They tried to offer the ability to search for the cost of procedures in a certain area but found the price could range a lot. Though they were able to find doctors with better efficiency and lower mortality rates than others this way, the data they had was raw and analytics capabilities were not as good as they are now.

 

George went on to explain how technology investments could enable better realization of efficiency. After all, hospitals have made huge investments in electronic health records due to government incentives in recent years. Providers (which are defined here as hospital systems and healthcare systems, which have been acquiring doctors and using them) found their systems needed to be connected together for better value. They needed an outside integrator to do this. Aetna even said 5-10% of healthcare happens in the doctor’s office or hospital, and the rest happens in the home.

 

So, it’s good to find ways to get data from smart homes and apps on your phone, creating a 360 view for a better patient experience. But part of the patient experience is price. You don’t want to be shocked by the price after the procedure! At the same time, not all procedures are the same, and this complexity makes it hard to say the price of each one.

 

Of course, technology will help with this ability to let patients know prices upfront. Healthcare technology can streamline systems and merge databases. But regulation and compliance are big hurdles. George explained that the most immediate driver is President Trump’s executive order around price transparency, which dictates that there will have to be price transparency given by providers and health plans so procedures can be shoppable. There’s not been a huge amount of work done at the state level yet compared to the federal level, but it will have to begin soon since consumers are starting to need it.

 

Overall, the gist of this podcast was that patients don’t care about overall price, but the cost to them and the outcome, such as whether they got better. They want value, which means they’re paying an affordable price for a good outcome. And the experts are starting to figure out what people are willing to pay for. With healthcare, they haven’t had enough data, especially providers, but now there is more in the last five years that can help put forth some good estimates. With better technology, we can help people see what they’re paying for, improve value, and enhance the patient experience.

 

Dan concluded that lots of work needs to be done, and systems need to go through more transformation before we can realize a digitally transformed healthcare system with price transparency. But that’s the goal! If you’re interested in learning more on price transparency in healthcare, listen to the full podcast today.