This is a big deal.  Integris Hospital system has decided to post prices for a few of the procedures done at their facility.  Now before you go off razzing them for the fact that MRI prices are not included in their imaging list and only a few surgeries are included you should stop to appreciate the significance of what this price revelation means.  What you are viewing is what was recently (very recently) declared an impossibility by the various hospital systems and their spokesmen.  What you are seeing is, I believe, only the beginning of their list.  This means that they felt an urgency to post what they had ready with more to follow.

Remember that Reason Magazine made Integris the whipping boy of their documentary about our facility and the overall lack of price transparency in health care in general.  This is, after all, the largest health system in the entire state.  By far.  This, my friends is the power of the market at work.  And as Rothbard would ask, “cui bono?”  Ah.  The patients!  What a tremendous development!  All the other hospital systems will almost certainly have to follow suit.

First, I would like to sincerely congratulate the folks at Integris for starting down this path.  Seriously.  This is a bold move on their part.  Up to this point, Deaconess Hospital here in Oklahoma City has been the “go to” full service hospital for pricing, so to see the mighty Integris join the crowd is great news for patients here in Oklahoma.  While Deaconess has provided me pricing for many inpatient procedures, all of the Integris pricing visible concerns outpatient procedures.  This is something I hope the folks at Integris will re-evaluate and expand.  Just as there is a tremendous, national demand for the procedures done at our outpatient facility, there is, likewise, a huge, national demand for transparently priced procedures more appropriately done on an inpatient basis.  Integris could join Deaconess as a medical tourist destination for value-seeking patients from all over the country (and Canada) if they continue down this path.

Many facilities have refrained from posting online pricing using insurance contracts or federal payments as their excuse.  Incredibly, this provided no obstacle for Integris and is perhaps the most ground breaking element of their price posting.  To have one of the giants forge what has been described by many as a contract-breaking,  price-posting path should embolden all others considering joining this movement.

The appearance of these prices in the absence of any legislated price transparency mandate is also notable.  This is powerful evidence of the fact that the power of the legislator’s pen pales in comparison to the pressures brought to bear by market competition.  Price transparency from a giant hospital system in the absence of a law requiring it.  Remarkable, indeed.

Now the hard part, part 1.  Bundling.  Note that the surgeon, anesthesia pathology, surgeon and radiology charges are not included in their listed fees.  This will likely be the hardest part for them, although as we have shown, it can be done.  Rest assured, I plan to call on them for an inpatient price as soon as I identify a patient that has come to me for help who would benefit from some of the great services offered there.  When they realize that bundled fees are the key to competing in this space, they will figure it out, I am sure.  Physicians on staff at large hospitals tend to distrust the administration, but many of the physicians working at Integris have been there since I was a medical student, indicative of the intense loyalty many physicians feel toward this hospital system.  This could work to their advantage on their bundling journey.

Hard part, part 2?  As the prices fall, facilities like Integris will enjoy the intense challenge of competing with facilities like mine on quality alone.  After all, how else is value determined when price differences shrink?  Unlike many in the health industry, I look forward to competing based on quality alone, knowing that the price deflation in health care here in Oklahoma City (and many other places!) was the result of the efforts of the finest group I have ever known:  the staff and surgeons at the Surgery Center of Oklahoma.  Good luck to all of you wishing to compete with the quality standard the staff at our facility has established.  Once again, the beneficiary of the new health care competition will be the patients. Congratulations, once again and welcome to those at Integris who have ushered in this momentous event.  

G. Keith Smith, M.D.