Value Your Health: 5 tips on talking to providers about costs

April 2, 2014  


Value Your Health

When it comes to health care, it can be difficult to determine services' exact costs.

That doesn't mean, however, that Purdue employees should ignore the issue of cost when they receive health care. Rather, employees should talk to their health care providers about the importance of managing their health care expenses responsibly, and they should be proactive in suggesting that care options be evaluated in terms of affordability, says Pam Aaltonen, associate professor of public health nursing and associate head of the School of Nursing. Aaltonen also served as chair of Purdue's Blue Ribbon Healthcare Committee and vice chair of the University's Health Care Strategy Committee.

Being a responsible and educated health care consumer can help employees keep their out-of-pocket costs low without compromising the quality of their care, Aaltonen says. Here, she provides some tips on talking with providers about costs.

Anticipate medical needs and research them.

Before visiting a provider, employees should consider which services the provider might suggest, Aaltonen says. The costs of most local medical services -- as well as office-visit and related costs -- are available on Castlight.

This tool allows employees to enter the name of a medical procedure, test, type of specialist or other aspect of health care. Once the name is entered, Castlight shows a list of providers and the costs and quality associated with each. Results are keyed to the searcher's medical plan, so the out-of-pocket costs reflected are as accurate as possible.  

Similarly, employees can peruse the Express Scripts website. Once they're registered, they can enter the names of medications to learn detailed cost information as well as whether generics are available for specific drugs.

For many health care services, Purdue's Center for Healthy Living is cost-effective and convenient, too.

Come prepared to visits.

It's a good idea to bring a list of questions to each appointment, Aaltonen says. That way, employees will ensure that they don't forget to ask providers questions whose answers might end up saving them money.

Questions might focus on cost as it relates to treatment options, specialist referrals, testing needs and facilities, or other aspects of care. Employees should list each question in order of importance. That way, they're assured to ask and receive answers to the most pressing questions first, Aaltonen says.  

Ask providers about costs early in the visit.

Since time with providers can be limited during appointments, Aaltonen says employees should be sure to initiate a conversation about costs early.

A good strategy might involve mentioning that cost is a priority early in the visit and following up with questions about cost when the provider suggests a treatment course. Realizing early on that cost is a factor in an employee's care might help providers tailor their suggestions for referrals or other aspects of care, Aaltonen says.

Additionally, employees should keep in mind their entire health care regimen. For example, if a provider suggests a new medication, employees should make sure the doctor knows all the medications they're already taking, particularly if multiple providers have prescribed them. This will ensure that the new medication or an existing one isn't unnecessary.

Approach providers about cost in a calm, matter-of-fact way.

It's important to broach the subject of cost with providers positively, Aaltonen says. Employees should remember that they are partners with their health care providers in managing their health, and that discussing cost is important in managing co-payments and deductibles as well as uncovered and out-of-network treatments.

When talking with providers about cost and care, employees should be clear that they value their health provider's input. It's also important for employees to recognize that providers often aren't accustomed to answering questions about costs, and that roles of providers as well as patients are evolving, Aaltonen says. 

Employees may be concerned that discussing costs would put them at odds with their doctors. However, not filling a prescription or following through with a treatment option due to costs results in gaps in needed medical care.

Employees who are reluctant to discuss costs with their providers can initiate a conversation by asking, "Is there a particular reason you want me to see that provider or specialist, or go to that lab or facility? Are there others you would recommend?"  Discussing choices or alternatives with providers will allow them to give their best recommendations.

Keep in mind that it is difficult for providers to know the actual costs for a particular treatment or test because many factors are in play. Efforts are underway across the country to increase health care's price transparency. 

If a required service is unanticipated, research the costs involved first.

Using the Castlight mobile application during appointments is an easy way to quickly research the costs of unexpected medical services.

If employees wish to take more time to research costs, or if they can't use the mobile app, they should feel free to tell a provider that they'd like more time before proceeding with a treatment plan, Aaltonen says. This might involve follow-up calls to the provider's office, so employees should find out any steps that will be required after they've completed their research.

Writer: Amanda Hamon Kunz, 49-61325, ahamon@purdue.edu

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