Healthcare: what’s in the price when you’re seen by a provider?

Story and images by BRADEN ROLLINS

Whether you go to the doctor to ensure your health shouldn’t be a decision you have to make. Unfortunately, rising healthcare costs are forcing individuals to choose between other expenses and healthcare.

Many face the daunting prospect of healthcare cost. But what contributes to the cost and why are some at a disadvantage as compared to others?

Stories of healthcare costs frequent the news and media attribute one of the causes of high costs to doctors offices themselves.

Trying to decipher why healthcare costs are so high can be difficult. However, speaking with employees at a local doctor’s office and their experience with rising cost may shed light on the subject for some.

Jordan Meadows, a small family practice located in West Jordan, provides services such as physicals, blood draws, weight checks, vaccinations and other basic medical services.

Debra Bowen, the general manager of the clinic, discussed factors that contribute to the price of healthcare in the office such as payroll, collections, supplies, utilities, and other miscellaneous expenses.

Keeping quality employees is difficult in today’s economy due to the unemployment rate being so low. And with major corporations offering higher pay for similar jobs, Bowen said it is difficult for smaller clinics to compete for labor.

Bowen said more than half of the expenses to the clinic is for payroll and if they were to significantly raise wages the patient prices would increase significantly as a result. So keeping the balance between quality employees and wages is a constant problem.

Another problem faced by the clinic is outstanding balances on patients’ accounts, which are usually sent to collections. Some patients receive treatment but delay paying for it at the time of service for various reasons. Many of these unpaid accounts can come from patients who have been treated and have since felt better and no longer feel payment is necessary, Bowen said.

Medical supplies are a major cost to the clinic. Bowen said most of the cost comes from sterile equipment for examination, followed by supplies and tests to diagnose different ailments. The most expensive of the supplies are vaccinations. The use of supplies is carefully monitored so only things that are needed are ordered to reduce waste and overstock of unneeded supplies.

While rising costs are affecting most Americans, Bowen acknowledged low-income individuals and families without insurance are particularly impacted. Jordan Meadows offers cash patients a reduced price for their care while barely breaking even on the cost to the clinic.

These individuals are faced with the decision to pay a high insurance deductible or pay out of pocket. Some coverage is minimal due to the plan selected by the patient.

Bowen said these policies, known as catastrophic insurance, have high deductibles such as $5,000, which most patients would not meet in their plan year, so they choose to pay out of pocket. 

This makes treating these patients difficult, especially those who have chronic care needs such as diabetes. Some patients will come in for their initial visit, but don’t return for follow-up appointments due to the price, which can sometimes cost over $100.

Though prices can still be considered high for cash-only patients, Bowen said they are negligibly higher than the prices set by government Medicare programs. Legally the clinic cannot charge lower prices than Medicare without it being considered fraud.

John Neilsen, a family nurse practitioner, said he and the clinic assist patients by reducing prices whenever possible for cash patients, and suggesting alternatives treatments and helping them find discounts on medications.

Neilsen said it is difficult at times when the patient cannot afford their care, but it’s even more difficult when the patient has the ability to pay but chooses not to afford their healthcare due to extravagances in their lives.

A main focus of the clinic is putting people first and doing what it can to help individuals struggling to pay for services by working with each one on a individual basis.

Mariana Alvarado, the receptionist who was assisting patients, said she has dealt with many patients who can’t afford the healthcare.

Many of the patients who have no insurance or poor insurance are notified before they are seen by the provider of the price of the visit. She says it’s difficult when patients are agitated by prices. But she said she does her best to calm them and explain why services are priced as they are.

Alvarado agreed with one of her co-workers. “Being a smaller clinic we develop relationships with our patients,” she said, “and do what we can to help each patient with staying healthy while helping them afford treatment.”

Jordan Meadows provides healthcare at prices that are manageable for the majority of its patients who have good insurance. But the clinic is willing to work with those who are in positions of financial stress or have poor insurance.

While basic healthcare could be considered relatively expensive as compared to other necessities, the breakdown of expenses to your doctor’s office, especially those of smaller practices, add up to and contribute to the final price of the service provided.

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