Obvious though it sounds, the easiest way for patients to cut their medical expenses in half may be to ask health care providers for a 50 percent discount.
Providers typically charge insured patients more than self-pay patients for the same services. Patients sometimes obtain discounts by paying for services in advance. Other times, patients or their insurance companies negotiate discounts after patients have received care.
Sean Parnell, author of The Self-Pay Patient: Affordable Healthcare Choices in the Age of Obamacare, says learning what doctors would charge for processing payments through insurers helps patients discern a fair cash price.
“The best advice is to skip negotiation altogether and simply go to a cash-only doctor that posts her prices,” Parnell said. “If that isn’t an option, I’d first go to a site like Healthcarebluebook.com to find out what insurance companies typically pay for an office visit or procedure, then tell the doctor’s office you are a self-pay patient and will be able to pay them immediately. Then ask for their best cash price.”
Paying up front saves providers the expense of tracking down payments from patients and insurers, Parnell says.
“Knowing what insurers pay them will let you know if you’re getting a real price quoted to you, and telling them you’ll pay cash immediately lets them know they won’t have to chase you for payment.”
For those intimidated by the prospect of haggling, the health care services firm Karis Group negotiates medical bill discounts on behalf of insurance companies and self-pay patients who have purchased membership in a health care sharing ministry (HCSM) as an alternative to insurance.
Tony Dale, Karis founder and board chairman, says patients should ask providers to lower their prices by more than half in exchange for up-front cash payment.
“Any patient who is ‘self-pay,’ including those who are a part of health care sharing ministries, should automatically ask for the self-pay discount if asked to pay up front for their medical care,” Dale said. “If they are offered less than 50 percent off the bill, they should turn it down and consider finding another provider.”
Dale said Karis has negotiated savings of approximately $200 million for HCSMs alone since 1996.
“Approximately 50 percent of our work is serving in the HCSM arena,” Dale said. “We also do similar work for various insurance companies, and our patient navigation services are available to around one million lives annually.”
Anthony Hopp, vice president of external relations at the HCSM Samaritan Ministries, says patients must be vigilant to overcome health care price obscurity.
“The lack of price transparency in the health care marketplace makes it important for consumers, especially those who are self-pay, to be active in their health care decisions and discerning about where they spend their health care dollars,” Hopp said.
Fair market prices emerge when patients and doctors do business with each other directly, Hopp says.
“Samaritan Ministries members are making better health care decisions because they are engaged, and doctors like working with Samaritan members because of the direct pay model, which offers less hassle and costs,” Hopp said. “As a result, members negotiate and receive discounts that bring the final bill closer to a fair market price.”
Michael T. Hamilton ([email protected]) is a Heartland Institute research fellow and the managing editor of Health Care News, author of the weekly Consumer Power Report, and host of the Health Care News Podcast.
Michael Hamilton, “Sean Parnell: A Shamelessly Uninsured Self-Pay Patient Saving Thousands on Health Care,” Health Care News Podcast, The Heartland Institute, June 29, 2016.
David Grandouiller, “Ohio to Require Medical Provider Price Transparency in 2017,” Health Care News, The Heartland Institute, November 2016: https://heartland.org/news-opinion/news/ohio-to-require-medical-provider-price-transparency-in-2017
Michael Hamilton, “HCSMs: The Holy Grail of Health Insurance Alternatives,” Consumer Power Report, The Heartland Institute, May 12, 2016: https://heartland.org/news-opinion/news/the-holy-grail-of-health-insurance-alternatives.
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