MyHealthMyPrice matches patients, medical services for less

Dr. Michael Tagge is bringing patients and doctors together for their mutual financial benefit.

MyHealthMyPrice, a Chicago-area service started by Tagge in 2012,

• Helps patients needing medical services to find doctors able to give them those services.
• Puts together a package deal for the service.
• Puts the patient’s payment in an escrow-like account.
• Releases the payment once the service is performed.

The package deals provide a flat rate that includes preoperative and postoperative visits, the procedure, surgery center costs, anesthesia, and any sort of necessary implants.

“If something goes wrong, the physician has to eat that cost, but it provides incentive,” Tagge says.

Patient financial risk is low. Even after a patient makes their payment, they can change their mind before the procedure is performed and before the money is released to the provider.

“If they don’t like Dr. A and they want to try out Dr. B, assuming their account is enough to cover that cost of that package, they can see Dr. B for the same amount,” Tagge says. “Any sort of extras are refunded.”

Tagge got the idea for MyHealthMyPrice while attending the Rosalind Franklin University of Science and Medicine and spending a lot of time in hospitals and doctor’s offices. He saw “the mess that is current medicine.” The Affordable Care Act “kind of threw a wrench into the works of how medicine is being practiced.”

“I don’t see a future for practicing medicine the way doctors should,” Tagge says. “I went into medicine to help people, and the way that everything’s turning out these days, it’s incentivizing excess consumption on one side and not really helping anyone on the other.”

MyHealthMyPrice’s business model can get lower pricing “because we guarantee payments to providers, significantly lowering their risk and alleviating typical cash flow and administrative burdens of dealing with other third-party payers,” Tagge says.

Prices sometimes end up being higher than what Medicaid and some insurance companies would pay, “which are nearly, if not actually, at charity-care levels.” This is a level of reimbursement that few practitioners will accept as it barely covers the actual cost of the services. The result is a severe restriction in availability and often quality, with long waiting lists, few options, and overbooked providers.

“But they are much lower than the prices you would typically pay by going through the insurance company at a higher level and more expensive delivery center, and much lower than the post-pay cash levels that assume the nonpayment risk,” the doctor says, adding that this gives MyHealthMyPrice’s patients maximal affordability and possible options.

The model “operates exclusively on prepayments,” Tagge says, so the risk of nonpayment or delayed payment as well as the “quagmire of insurance payments” is removed.

Patients get transparent pricing; physicians compete on transparent pricing.

“Doctors know they’re going to get paid timely and that makes a huge difference in the way they do business,” Tagge says. “Patients have complete power over their money until they actually start the procedure. They can choose which provider they want from the options given. They have actual choices.”

MyHealthMyPrice has assembled an informal, no-cost network of medical providers. “We come up with common treatments and put together the whole package,” Tagge says.

Even if a patient’s preferred provider is not within MyHealthMyPrice’s “network,” Tagge says he will reach out to that provider to try to create a treatment plan. But all finances continue to be clear from the beginning.

“There’s no question how much you’re going to pay,” he says. “You know exactly the full amount going into the procedures so you can plan for that.”

MyHealthMyPrice even has a type of layaway option, “which is a low-cost option to kind of save up,” and traditional credit-based financing.

“We find different avenues for patients to get care when they need it and kind of work out the details around that,” Tagge says.

Services at this time are “all over the place,” but MyHealthMyPrice is lately emphasizing hernia operations, “though it exists within our capacity to tap into our network for a huge variety of different cases and kind of put together patients’ specific plans.”

Tagge says he hopes that MyHealthMyPrice “creates consumer-friendly competition.”

“All in all, consumers are going to win from this and doctors will have much more competition than they currently do.”