Coming soon to a hospital or clinic near you: dynamic healthcare pricing.
It’s not here yet, but Jay Deady, CEO of Recondo Technology, believes it’s on the way. He expects his revenue-cycle management company to enable the service. Healthcare providers will soon be able to offer different out-of-pocket prices depending on when and where each patient goes for a given service, he said.
For example, the price of medical imaging usually is higher in a hospital than in a doctor’s office or a standalone imaging center. But if the hospital’s radiology department happens to have available slots or the patient is able to wait a few extra days, the insurance company could offer a lower co-pay, or waive the member payment altogether. Conversely, the price may be higher if demand dictates.
“It’s very common in other consumer verticals, but very new to healthcare,” Deady said at HIMSS16 in Las Vegas. And it’s becoming important in healthcare, now that so many Americans have high-deductible health plans, and thus are more sensitive than ever to out-of-pocket costs.
Greenwood Village, Colorado-based Recondo last week introduced MySurePayHealth, a consumer-facing price calculator offered through provider portals. Recondo pulls in live data from payers to calculate out-of-pocket costs based on member-specific health plans, and can even help consumers manage their deductibles.
This technology, according to Deady, eliminates the need for health systems to staff large call centers to remind patients of their financial responsibilities in advance of an office visit or medical test. Because users can pay online before they arrive, some providers already are offering patients prepaid discounts against the initial cost estimate.
A Deep-dive Into Specialty Pharma
A specialty drug is a class of prescription medications used to treat complex, chronic or rare medical conditions. Although this classification was originally intended to define the treatment of rare, also termed “orphan” diseases, affecting fewer than 200,000 people in the US, more recently, specialty drugs have emerged as the cornerstone of treatment for chronic and complex diseases such as cancer, autoimmune conditions, diabetes, hepatitis C, and HIV/AIDS.
“If they collect upfront,” Deady said of providers, “the likelihood of getting paid on the back end increases by 600 percent.”
Eventually, this technology will be the basis for dynamic pricing, Deady said.
Photo: RRY Publications/Wikimedia Commons
