Healthcare Price Transparency and the Mystery Bill

It's usually the patient waiting for the doctor, but this time it was the other way around.

When I arrived at the doctor's office 20 minutes late for my scheduled appointment and they still accepted me in, I was quite pleased.

The fact that my doctor's visit for a skin condition only took 15 minutes made me even more excited.

That aura stayed with me for a little more than a month. Then I was impressed even further when the bill came in the mail and was for less than $50. I can still remember that day last November when I told my wife we would probably have a little extra money for Christmas.

Little did I know that I was wrong.

A couple of weeks later, there came an unwelcome surprise, what I'll call a mystery bill. Yes, another bill, unexpected and separate from the first one. It was for more than $500.

There went my excitement.

Now $500 isn't too bad when it comes to healthcare, or at least, that's what we've been trained to think. That training, maybe better termed as history or expectation of how things supposedly work in healthcare, is not good. I'll even say that, from a consumer standpoint, it's incorrect.

Perhaps you or someone you know well can relate to the healthcare mystery bill. It's not fun. I don't know anybody who is a fan of a mystery bill.

Fueled by a mission to create transparency and improve healthcare, we at KLAS have put research muscle and investment into the emerging market of price transparency solutions. The goal in this space is simple: vendor solutions should help empower the consumer to compare and shop for healthcare services, thus helping to facilitate an open and competitive pricing market.

That competition and transparency should (over time) drive healthcare services to a pricing equilibrium, thus resulting in more knowledge, better options, and eventually better outcomes for consumers.

Contrast that ideal state with today, when price and quality transparency for healthcare services are often foreign concepts. And though KLAS will soon have a published report about the effectiveness of vendor solutions in this space - including those used by providers, payers, and consumers - it all starts and ends with consumers.

That means it starts with you and me.

So next time you need to schedule an appointment or a service with a doctor, take the initiative to ask what the pricing will be. Be bold and ask about the quality of the service and other patient reviews. You might be taken aback by what you hear or even by what you don't hear.

Either way, that's how we start to carve the mystery out of that mystery bill.