Shopping for consumer friendly surgery packages shouldn’t be an exercise in futility.
Which city has the lowest cost surgery? More to the point: which city offers surgery packages that include your surgeon and the anesthesia, facility, and other things you will need all at a clear, transparent price? Are there choices you can compare?
These questions are increasingly important because, driven by rising cost and contraction of choice, we act increasingly as healthcare consumers. Consumerism is the norm for many types of surgical procedures that are often not covered by insurance plans: vision correction, vasectomy reversal, breast augmentation, and others. Driven by higher deductibles, consumerism is also increasingly the norm for procedures that are covered: hernia repair, knee arthroscopy, nasal polyp removal, and others. Let us consider what happens to you if you need a procedure that your insurance does not cover.
Suppose you have diabetes, obesity, or a history of prostate cancer surgery and as a result have erectile dysfunction. Suppose further that such common treatments as Viagra, vacuum pumps, and injections no longer work for you. Your remaining choice is penile implant surgery, which insurance often does not cover. In this case, as with all procedures, you want a qualified surgeon. So how do you find a qualified surgeon? Is there a credential should you seek? Medical school? Peer reviewed publications?
The question of surgeon qualification is seemingly as elusive as the fountain of youth. We are talking about real surgical quality – blood loss, infection – and not how much parking was available at the doctor’s office. You want to know your surgeon knows how to handle a scalpel. How do you get at that?
One method for qualifying surgeons is implied in Blink, a book that examines the snap judgments of subject experts. For example, the book describes how an expert tennis coach can instantly tell that his player is about to double fault in a way that cannot be reduced to formula.
And so it is with surgeons: a master surgeon can tell quickly if another surgeon is any good. As put recently by highly experienced reconstructive urologist: “I can tell within two minutes of skin incision if another surgeon knows what he’s doing.” The idea that surgeons can spot other good surgeons in a way that correlates with clinical outcomes, e.g. readmission, has been validated scientifically, too. It seems that surgeon peer credentialing may be the best way today to get at surgeon quality.
The Federal government and employers take on financial risk for healthcare. With rising costs, they are increasingly asking questions about cost and value. This is leading to changes by the providers. Notice, for example, that some states are beginning to mandate price transparency and that some facilities are starting to make efforts to voluntarily publish cost and quality measures.
As an individual healthcare consumer, you also want value but you do not have the leverage of the Federal government or a large employer. So how do you get at value as you reach out for quality, too?
You can certainly call surgical facilities to ask about their services and related surgeons and costs. This generally goes badly. Consider a recent case in Tennessee, in which a hospital told a prostate cancer survivor that penile implant surgery would cost $60,000, not including anesthesia, surgeon, or implant. In other words, they offered a part of the package he would need, but not the whole package he would need. This is not reasonable. It is virtually impossible for an individual healthcare consumer shop individually for his anesthesia, prosthesis, and so on. Calling surgery facilities will in most cases leave you exhausted.
You can also turn to the internet and search for such general terms as “penile implant.” This is likely to yield theoretical, but not practical, material that answers questions about quality, cost, and choice. Like calling surgery facilities, shopping the internet for practical solutions is likely to end in exhaustion.
Driven by broad societal and internal pressures, providers are changing the online and off-line worlds to better serve the individual healthcare consumer. For example, a group of surgeons is designing and participating in a consumer directed market of surgery packages that delivers quality, convenience, and choice. For quality, they are bringing in the surgeons they would use if they needed surgery. For convenience, they are wrapping every surgeon in the anesthesia, facility, and other things you would need. They are pricing transparently and putting the packages online.
This provider side reform has real, useful implications for you as a healthcare consumer. If, like the man from Knoxville, you now search instead for a more targeted “penile implant surgery packages,” you will find answers that are practical: which surgeons, what costs, which locations. In his case, it delivered 10 choices side by side and let him easily choose a nearby package that delivered 60% savings. A transparently priced, surgery package market can do the same for you. It can do it for any procedure.
Consumerism is coming to healthcare. As a result, we are seeing signs that the pressures are trickling to the level of the individual healthcare consumer. We are seeing surgery packages as one mechanism by which individual healthcare consumers can more easily find the service they need. If you are heading to surgery, look for surgery packages and keep your eyes open to quality, cost, and choice.
Co Authored by: Arnon Krongrad & Kimberly Langer