When you go to the grocery store, everything has a price clearly marked.
But not a doctor’s office.
Complex insurance and billing systems mean patients usually don’t know how much they’re going to have to pay until after a visit.
A new Oregon company is trying to change that — by giving patients a price up front.
Kristian Foden-Vencil visited a Zoomcare clinic in Northeast Portland and files this report.
Dr. David Sanders is very proud of his latest clinic in Northeast Portland. It’s the seventh in a chain that has been sprouting up across the metropolitan area over the last five years.
David Sanders: “It’s right in the heart of a neighborhood. It’s bright and shiny and colorful. It’s meant to be really fun, even when you’re sick, to be able to come to Zoomcare, feel comfortable, come right in and be seen by a doctor.”
Sanders practiced medicine in Portland after graduating from medical school in Los Angeles. He says he and his business partner, Dr. Albert DiPiero, tired of the established medical system.
David Sanders: “The problems that we encountered when we went out into the world, were not at all what we expected when we first began training. We had no idea how medicine was really practices.”
So in 2006, they opened their first Zoomcare clinic in Tigard. The idea was to treat a patient more like a customer — someone who cares about quality and service, but also about price.
Dr. David Sanders: “A typical doctor’s office will have hundreds of prices. Truly hundreds of prices.”
Patty Wentz is a spokeswoman for the Oregon Health Department. She says price is a growing concern for health consumers. And that concern is driving proposals for change to the health care system.
Patty Wentz: “I mean people really want to know what they’re buying and that they’re getting value for their healthcare dollar. That’s some of what is happening with the Oregon Health Insurance Exchange — the central marketplace for insurance that’s under discussion in the legislature right now.”
Sanders says Zoomcare puts prices on the web for anyone to check. If you pay out of pocket for a foot splint, the extraction of a corn kernel from your child’s nose, or treatment of a burn, the fee is $99.
If you’re insured it’s $129.
Sanders says the 30 percent extra pays for all the paperwork costs associated with insurance.
Rachel Lemeke is a physician assistant at Zoomcare and says her patients seem to appreciate the transparency.
Rachel Lemeke: “We do have a lot of patients who don’t have health insurance so there are lots of questions about how much test A B and C is going to cost me and so here at Zoomcare we’re trained to be really familiar with the cost of the test that we’re ordering and really making sure that the test are going to change the treatment plan before we ask a patient to spend another $20 or $40 on something. Whereas other clinics I’ve worked at in the past it’s not so transparent to the providers either. We don’t really know how much the tests are that we’re ordering and so patients suddenly get this bill for $400 and neither they nor I knew that that was going to be the case.”
Kristian Foden-Vencil: “Do you think they feel difficult about placing a price on their health?”
Rachel Lemeke: “I’ve been surprised at how many times they are willing to put a price on their health. Even patients I feel are too sick to be seen here and need to go to the ER it still often times takes a lot of time coaxing or convincing because they don’t want to spend $1000 to get IV fluids or whatever it is they may need at the ER.”
One way Zoomcare keeps costs low is to use fewer doctors and more nurse practitioners and physician assistants — like Lemeke.
Portlander Dave Chase dropped in for his annual check-up after hearing about the company.
He’s new to town and didn’t have a doctor. He says the service was clean and fast.
Dave Chase: “During the course of the appointment. There was some things like, I was due to get a tetanus shot. And the clinician could pull it up right there, Oh, that’s going to cost whatever, $74.
Kristian Foden-Vencil: “Did they actually say that at the time. Or did they show it to you? What I mean is, it’s not like ordering at a restaurant, it’s your body. But you also what to know, right?”
David Chase: “Yeah, right. He’s entering stuff in the computer and they have a screen so you can see exactly what he’s typing and so then he looked that up and said, here’s what it is.”
While price transparency is something consumers want, it’s not a silver bullet for containing healthcare costs.
Patty Wentz, of the Oregon Health Department, says that’s because companies like Zoomcare only deal with people who aren’t that sick.
Patty Wentz: “In healthcare about 80 percent of the costs come from 20 percent of the clients. With the Oregon Health Plan that’s people with chronic care, with multiple conditions, people who need a lot of services. And where you see the costs is when they go to the emergency room for those services.”
With the average deductible in the U.S. now up to $1200 — and bigger co-pays — more patients are looking at the bottom line — even if when they’re insured.