Consumerism & Price Transparency in Healthcare: Patients are the New Payers

A quiet revolution in healthcare payments has been taking place and it is building into a tsunami as out-of-pocket spending for healthcare has skyrocketed. In 2022, patients are the new payers and they are expecting the same digital experience they are accustomed to in every other industry.

During a September webinar organized by HealthMe, a software solution designed to accommodate direct-pay in medical offices, an expert panel of healthcare and clinical leaders discussed how patients and payers are now actively “shopping” for care and in turn are expecting better information and more transparency from healthcare providers.  Panelists were:

  • Jonathan Wiik, nationally recognized healthcare speaker and author of “Healthcare Revolution: The Patient is the New Payer.” 
  • Mike Havig, MD, Practicing Orthopedic Surgeon and CEO, HealthMe
  • Kim Wishon Marden, Chief Executive Officer of Watauga Orthopedics

The webinar was moderated by Mark Plaster, MD, JD, founder and executive editor of Emergency Physicians Monthly.

Three key takeaways were:

Patients are demanding price transparency and tools to help them shop

According to Wick, “Patients now are responsible for a third of their medical bill as deductibles have increased by 111% over the last decade.  Effectively 1 in 5 patients are categorized as underinsured.”  As patients are forced to pay out of pocket, they are demanding pricing transparency and tools to help them shop for services across the continuum. Wick added “today we can shop online for everything except healthcare,” and according to a McKinsey & Co study, 82% of patients want to shop for their healthcare online and can’t.   He closed with “It is critical that practices marry the delivery of care with a good patient financial experience in order keep their patients coming back.”

Healthcare providers must act now to meet this demand to be compliant with Federal Law

When a patient wants to pay directly, studies have shown that 90% of offices will turn this patient away rather than interrupt their current workflow.  Starting in January 2022 with the No Surprises Act, patients have the right to request a Good Faith Estimate (“GFE”) explaining how much medical care will cost prior to service.  Price transparency is now a “must-have” for practices.  Dr. Michael Havig, CEO of HealthMe, stated that the HealthMe platform “gives office staffs an automated turnkey solution to help serve this growing patient population and remain compliant with GFE requirements.”

It’s the “right thing to do” and a proven revenue driver for practices

Watauga Orthopedics in Tennessee adopted HealthMe’s platform in 2022 primarily to accommodate patients who entered their practice via the local hospital’s trauma centers.   Kim Wishon Marden began her remarks with “We did it because it was the right thing to do and a lot of healthcare executives believe in price transparency.  We were shocked at how many self-pay patients have come to us because we have our prices listed and it is very easy for them to use.”

Watch a highlight video of the webinar here.

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