Patients can Shop Online for Medical Procedures

Consumers can shop online for cars, clothes, and even romantic partners – but medical care?

Yes, medical care.

Medibid, an auction site founded by Ralph Weber, offers patients the opportunity to solicit bids for a variety of medical procedures from doctors enrolled on the site. For a tiered subscription fee, patients and doctors alike can either place or bid on single requests or unlimited requests. Once the patient accepts a bid that covers the full cost of the procedure, they make arrangements directly with the physician and pay for services by cash or credit card in full.

Proponents of bidding for medical service, including Weber, argue that this development is an organic evolution of the online marketplace that will allow consumers to take control of their healthcare spending in a way that insurance providers and hospital systems do not. Medibid providers, who are largely in small practices or run their own surgery centers, are able to charge lower fees without compromising their profit margins because they can skip the costly step of billing insurance plans.

However, a number of critics point out several drawbacks to the online auction approach to medical care despite acknowledging the difficulty of navigating (and paying) hospital prices. Red flags include fewer regulations of physician-owned outpatient centers, lack of “quality indicators” to support the doctors bidding on procedures, and the potential for complications that are not covered by the Medibid agreement.

Hospitals may be getting the message – a number of hospitals around the country are beginning to post their procedure prices (minus surgeon’s fees) on their Web sites. The aim of hospitals that choose to do so (and the states that have mandated the practice) is to help patients make the best decisions for the care based on price and quality.

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ACA: Consumers Face “Sticker Shock” with New Healthcare Plans

Consumers signing up for new ACA-compliant healthcare plans may choose a lower-tier plan to save money, but the decision comes at a high price – that is, increased deductibles and other out-of-pocket costs.

As previously reported, available plans fall into one of five cost categories that feature increasing premiums but offer decreasing deductibles in exchange. Premiums for all plans are higher than 2013 premiums, but individuals who earn up to four times the national poverty level can qualify for tax credits to offset their premiums.

Consumers who purchase at least a silver plan and who earn up to 2.5 times the poverty level can apply for additional credits to offset deductible and out-of-pocket costs, further relieving the burden of care. However, consumers who cannot receive the extra assistance may bet on their own health and choose a more affordable monthly payment over better coverage.

Higher deductibles could create scenarios in which patients forego needed care to avoid a hefty bill, which runs contrary to the purpose of the ACA, or they receive care and are later unable to pay the bill which contributes to hospitals’ bad debt.

Despite the unpleasant news, the ACA also caps annual out-of-pocket expenses (including co-pays) for an individual at $6,350 – a large number, but significantly lower than past plans that may not have capped expenses at all. This may ameliorate some of consumers’ sticker shock, particularly for patients whose cost of care quickly exceeds that threshold due to serious injuries or chronic conditions. Also, well check visits and prescriptions are covered at varying levels as minimum essential benefits and are deductible-free in some cases.

The best advice for individuals still shopping for the right health care plan is to consider not only the up-front cost of a monthly premium, but also the real cost of using the plan should the need arise.

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