Part 2 of a series From Guest Author, Neil Smith, PA-C, MBA, Founder and CEO of Symbia Allergy Solutions.
Higher Healthcare Deductibles
Here’s the back story….The little secret that paying out-of-pocket for healthcare can reduce the cost of care is no longer a secret. According to the Kaiser Foundation, in the past five years, consumer deductibles have risen nearly three times faster than premiums and about seven times faster than wages and inflation.
As a result, even if a healthcare expense is covered by an insurance policy, patients are likely to prefer to pay for it out of pocket, even if they are insured. Indeed, cash-pay-healthcare marketplaces are popping up, connecting medical practices, that offer a cash-payment option, with patients who value cost transparency and lower prices for cash-payment. MyChoiceMD.com is one example.
Drops vs. Shots
All of this to say that your patients are likely to be willing to pay for allergy drops out-of-pocket , especially when confronted with the high cost of allergy shots and/or ongoing allergy medication use. Allergy drops, aka sublingual immunotherapy, contain the same active antigens as allergy shots, but are administered as a drop under the tongue, instead of as a shot.
Because the sublingual route is considered to be “off-label”, there is no CPT-pharmacy code available and health insurances do not reimburse this treatment. However, the evidence for SLIT as an efficacious-safe-more-convenient alternative to allergy shots, is well-established. The drops are also a more-cost-effective option, compared to allergy shots. This is because the drops require much fewer office visits and there, obviously, are no injection fees charged with the drops, in addition to the serum fees.
Presented with the opportunity to gain long-term allergy relief, taken as a painless drop under-the-tongue, in the comfort of their own home, for a transparent-cash price, your patients are likely to not only be amenable to pay for allergy drops out of pocket, but may actually prefer doing so.
See the previous article in this series “Do Allergy Drops Really Work?”