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The Trouble with the Lack of Transparency in Healthcare

Just a few years ago, Australia was ranked as having the second-best health care system in the developed world. Fast Forward to 2020, and the continent dropped five places to #8. It’s also experienced a decline in rankings for transparency, from #7 in 2019 to #9 in 2020. This second category examines whether or not a nation has open business and government practices and high levels of trustworthiness.

Why the drop in ratings? One reason is cost.

According to the publisher of these rankings, being seen as having a well-developed public health system is one of nine attributes used to develop the Quality of Life sub-ranking in the Best Countries report. Australia boasts a national health insurance program primarily delivered by the government through Medicare. The continent utilizes a dual public-private system, with states taking the majority of responsibility for public hospitals, ambulance services, public dental care, community health services, and mental health care.

However, health care spending in Australia continues to increase, with approximately $185 billion – $7,485 per person – expended annually. Plus, individuals contribute more than half of the non-government funding. Australia has the third-highest reliance on individual health care contributions, behind only Switzerland and Belgium. Almost half of the nation’s residents buy complementary and supplementary coverage for private hospital care, dental treatments, and other services. 

Another reason for Australia’s reduced health care rankings is a lack of transparency. Although its system is more transparent than most, one global study places it in the second tier of transparency of health systems behind the Scandinavian countries. The study, which was based on the quality of health care, patient experience, finance, governance, personal health care data, and communication of health care data, noted that further progress could be made by publishing more data in open formats.

Challenges of inconsistent costs

These problematic issues don’t exclude Australia’s dental industry. There is no law preventing private specialists from charging whatever they want. There’s also no legislation that forces these practitioners to notify patients in advance of fees to treatment and services.

The United States government recently tackled this transparency issue by issuing its CMS Final Rule on Price Transparency, which takes effect on January 1, 2022, and gives health care consumers in that country increased access to providers’ prices for multiple services and procedures. It’s an important step for a country that, even with health care spending at a level almost twice as much as the average developed country, has a lower life expectancy and worse health outcomes than any other high-income nation.

Although Australia offers both public and private dental services, 20 percent of residents’ out-of-pocket payments go toward dental care. Half of all Australians claim for dental services through a health fund, but many are unable to avoid out-of-pocket contributions to the majority of dental services, that Medicare does not cover. In addition, the rebate Australians receive back from their fund only compensates them for about half of the cost of dental treatment.

It’s no surprise, then, that concerns about dental costs deter some Australians from receiving routine care. Without transparency, many patients are unsure of how much they owe their dentist or how to pay their bill and therefore are more likely to be slower in paying. Those without complementary and supplementary coverage are more likely to altogether forgo dental care due to costs.

Even if an individual has enough to cover the cost of these services, there often are variations in prices and fees from different dentists for similar procedures. Patients can receive the same treatment but end up paying drastically different prices. And, private health insurers try to prompt their members to utilize the dentists with whom they’ve contracted, even if it disrupts the continuity of care.

There are some government initiatives developed to make dental care in Australia more affordable, but they fall short of providing coverage for a majority of the population. For example, the Child and Adult Public Dental Scheme provide coverage for roughly 5.3 million children under the age of 18 and about five million low-income adults, but that only covers approximately 40 percent of the nation’s total population. Even with the Australian government’s commitment to doubling its investment in the public dental program to AUD5.0 billion, routine care is still unattainable for many residents.

Broad benefits for Australians

The benefits of transparency in dental care and health care overall are many. Not only does it help reduce costs and improve patient satisfaction, but it also allows for easier comparison of products and services through better pre-procedure knowledge of prices and fees. Patients are better supported in their health care decision-making and have increased knowledge of their responsibility for payment.

Real-time access to estimated out-of-pocket (OOP) costs mitigates the chance of a patient receiving an unexpectedly large dental bill and improves the overall payment process for them. Transparency in health care also can positively affect patients through reduced market prices for various procedures due to increased provider competition.

For dentists and other health care providers, this transparency often results in more profitable revenue collection from a lack of surprise medical bills. It promotes patient engagement, which the World Health Organization (WHO) defines as “the process of building the capacity of patients, families, carers, as well as health care providers, to facilitate and support the active involvement of patients in their own care, in order to enhance safety, quality and people-centeredness of health care service delivery.” Patients who are fully engaged in their care are more likely to maintain treatment plans, track their health, and ask their providers questions. 

According to one health care expert, health care price transparency should consist of four key benefits: better-informed consumers and patients; better-informed employers who help workers shop for value; the improved ability for employers to monitor insurer effectiveness and eliminate counterproductive middlemen; and public pressure on high-cost providers.

To assist Australian consumers in managing out-of-pocket costs, the federal government offers a free transparency website. The Medical Costs Finder helps them understand the cost of common medical procedures provided by specialists on the continent. Similarly, the Australian Dental Association (ADA) developed its own free comparator website for the dental component of extras policies.

The AirSmile advantage

At AirSmile, we provide an innovative digital platform designed to make quality dental care accessible to all Australians. Our platform is free and makes it simple for patients to find a dentist that meets their specific needs and values.

AirSmile dentists are committed to providing high-quality and transparent dental care, an important asset for consumers looking to receive good service and a level of value that is important to them. Patients only have to search on the website or download AirSmile from the Android Google Play Store or iOS App Store.

 For dentists, we ensure our platform works for you by bringing in more patients, especially those interested in routine care or with a significant amount of dental work. By bringing these patients to a single platform and connecting them with your clinic, you achieve reduced marketing costs and only pay per patient booking.

Patients introduced to your clinic by AirSmile have already used our platform to scope and plan their treatment, so they’re aware of treatment costs before setting a foot in your practice. You maintain control over your fees and can integrate our platform with your practice management software and systems to manage all your appointments. Also, our portal transfers you the bookings and records, enabling you to plan and treat with confidence.

This article was authored as a collaboration amongst the AirSmile team.

If you’d like to find out more about how AirSmile can help you as a patient or dentist, you can get more information on our website.

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Heath Fraser

 

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