More Providers and Payers Use Bundled Pricing to Serve Patients with High Deductibles in a Trend That Has Financial Implications for Clinical Laboratories

This phenomenon is a response to the tens of millions of patients who now have high deductibles that must be met before their insurance kicks in

There’s a new wrinkle on bundled pricing for medical laboratory tests and other healthcare services. Some providers and payers are creating bundled pricing options specifically for the tens of millions of patients now covered by high-deductible health plans (HDHPs).

Patients covered by HDHPs are responsible to pay thousands of dollars out of pocket before their health insurance kicks in. Thus, it should not surprise clinical laboratory professionals that providers and health insurers are collaborating to created bundled pricing (AKA packaged pricing) options that cater to self-pay patients.

Bundling is a method in which healthcare services are grouped together for one pre-determined price. It is intended to decrease costs while providing patients with increased access to high-quality care. Clinical labs and pathology groups will need to negotiate with the organizers of these bundled medical services in order to get adequate payment for their testing services.

Bundled service options are gaining in popularity because more Americans are paying out-of-pocket for medical care. Some people have no health insurance coverage at all. Meanwhile, tens of millions of Americans are enrolled in high-deductible health plans. These patients are typically responsible for paying thousands of dollars in out-of-pocket expenses before their health insurance begins paying for medical services. With so many people seeking more economical choices for their healthcare needs, providers, hospitals, and health insurers are exploring the options bundled pricing offers. (more…)