Specialist fee transparency website launched – but without individual fee data


By Michael Woodhead

21 Jan 2020

A specialist fee transparency website has been launched by the federal government but does not provide data for individual practitioners and does not focus on cancer specialists as originally pledged.

The Medical Costs Transparency website provides broad examples of typical out-of-pocket costs for 62 procedures in 23 areas of practice, most of which are not related to cancer.

The website provides examples of low, average and high levels of out of pocket fees that patients can expect to pay for procedures in specialist areas such as gynaecology, joint reconstruction and weight loss surgery.

The procedures relating to cancer include breast surgery, colonoscopy, prostatectomy and removal of skin lesions.

For breast biopsy (MBS item 31506) the website shows that at a national level the average out of pocket fee for privately insured patients is $450 and with 17% of patients having no gap fees.

It provides more in-depth financial information, showing that total doctor fees for the procedure range from $1600 (low) through $2200 (average) to $3000 (high).

With government subsidies covering $1000 of the fees and private insurers typically paying $730, this leaves a out of pocket fee of $450.

The site also shows how out of pocket fees vary between states, with breast biopsy likely to results in patients being $600-$850 out of pocket in NSW and ACT but only $80 in South Australia.

In March 2019 Federal Minister for Health Greg Hunt said a website site would be developed to help patients avoid bill shock, with an initial focus on fees for gynaecology, obstetrics and cancer services.

The minister said a national searchable website for information on specialist fees would help tackle excessive out of pocket costs by empowering patients to make informed choices when selecting a doctor.

“Specialists will initially be expected to show their fees as agreed with the medical profession on the website to enable patients and GPs to consider costs when determining their choice of specialists,” said Mr Hunt.

However he added that participation by specialists would be voluntary and some specialists have since commented that they think it unlikely that many doctors will provide information about their individual fees.

The website was described as a disappointing first step by the Consumers Health Forum.

“The Medical Costs Finder website is an inadequate response to the need for an open and comprehensive presentation of individual doctor’s fees and likely out of pocket costs said CEO Leanne Wells.

“But it is a start and we hope just the first step towards a system in which all doctors’ fees are published,” she added.

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