Price Transparency in Healthcare

As a business owner, one of the most appreciated benefit offerings to our own employees is a price transparency tool. As one of the first agencies in Dallas to deliver the valuable behavior modification tool, it is amazing to see the product now being offered across the entire nation in under a decade. With over 2,000,000 members now covered, from the Houston Rockets to the employees of Southwest Airlines and Michaels, your employees could also benefit from a true concierge program.

As we implement plans with increased deductibles and copays, we need to give employees the tools and skills to support their efforts to become good consumers of healthcare. All of us have tools to price a vehicle before we head to the car lot. Few of our employees have ever had a tool to price a surgery, the price of which could be comparable to purchasing a car. We do not stop to analyze how much the surgery, the surgeon, the surgery center or even an MRI or prescription drug will cost prior to the procedure being performed. Our transparency tool can compare many choices side by side, and will take it a step further and schedule the appointment, complete the follow up and review the bills after they have been processed if your employees have questions.

Think of the potential dollar savings to your plan, and just as important, the time saved by your employees and the increased satisfaction level as they truly have a patient advocate working for them, hired by you.

For more information, contact Sharon McReynolds: smcreynolds@medconbenefit.com or 214-739-5215.

Health Care Consumerism: 22 Ways to Cut Health Care Costs

The way we purchase health care is unlike most other purchases we make. Many Americans will search through a newspaper for a coupon that saves them 50 cents at the local supermarket. However, when it comes to health care—a far more complex and expensive service—we rarely ask questions or consider all the options that could save us time and money.

Learn to shop for value when it comes to health care. With little effort you can save thousands of dollars on your medical bills. Share these helpful tips with your employees regularly to promote educated decisions when choosing health care.

1.     Let’s make a deal. Ask your doctor, hospital or dentist if they will accept less. Studies show that the majority of individuals who bargain succeed.

2.     Know how much it costs. You will be better armed to negotiate discounts when you know the real costs of care. You can find rates on the websites of large insurers like UHC, Cigna and Aetna.

3.     Pay in cash. You can often save up to 10 percent on your bill by paying in cash up front. Doctors lose thousands of dollars each year on credit card processing fees, unpaid bills and collection fees.

4.     Look at your bill closely. You will often find mistakes. Keep track of your visits, tests and medications, and compare them against your bills. Request a corrected bill if you find an error and notify your insurance company.

5.     Follow instructions. Follow your health care provider’s instructions for medications. Most medications work most effectively when they are used according to doctor’s instructions. Ignoring instructions could result in additional prescription costs, extra trips to the doctor or even hospitalization.

6.     Visit a retail health clinic. Retail health clinics are growing in numbers. They are popping up in high-traffic retail outlets in metropolitan areas around the country. While these clinics lack the personal nature of seeing a family physician who knows your complete medical history, their appeal is the convenience and low prices advertised for all to see.

7.     Stay in-network. Your medical costs can increase greatly when you visit a provider not in your plan’s network. Make sure your primary care doctor and any specialists you may need to see are in your network whenever possible.

8.     It doesn’t hurt to ask. If you must see a specialist who isn’t within your network, call your insurance company’s pre-certification department and explain why you must use an out-of-network specialist. Often times you can get your insurance company to agree to pay at in-network rates in order to avoid the expensive appeal process. If that doesn’t work, ask your specialist to accept the in-network rate.

9.     Fight back. If your claim has been denied, start with a phone call to customer service. If that doesn’t work, follow your plan’s appeal process. Remember to document everything and keep copies.

10.     Choose your health plan wisely. Sticking with the same plan year to year may not be the smartest option. Anticipate your family’s medical expenses and look closely at each plan option to find the most appropriate and cost-effective one for you.

11.     Consider an HSA. Health Savings Accounts (HSAs) are growing in popularity. They are combined with a high-deductible health plan. The high-deductible policy protects you from the cost of a catastrophic illness or prolonged hospitalization. You control the savings account and use it for small and routine health care expenses. You will save about $1,500 in taxes for every $5,000 you put into an HSA. Funds you don’t use grow tax-free and can be rolled over from year to year.

12.     Take advantage of flexible spending accounts. A flexible spending account, or FSA, is an employee benefit program that allows you to set aside money on a pretax basis for certain health care and dependent care expenses. That means you keep more of your money. For every $1,000 you put in, you’ll save approximately $300 in taxes.

13.     Don’t skimp on preventive care. Be sure your child gets routine checkups and vaccines as needed, both of which can prevent medical problems (and bills) down the road. Also, adults should get preventive screenings recommended for their age to detect health conditions early. Many of these services are now provided at no cost through employer-sponsored health plans.

14.      Visit a dental school. Look into local dental schools where you will be treated by dental students, who perform the dental treatment closely supervised by their instructors. Expect to pay about 20 to 60 percent of what you’d pay for the same treatment by a private dentist.

15.     Don’t forget to floss. Studies have demonstrated that those who floss regularly have a decrease in periodontal disease, bad breath and cavity incidence. The cost of periodontal disease treatment can range from $200 to $2,000 per procedure.

16.   Discount contacts. Discount websites and stores can provide the exact contact lenses prescribed by your eye doctor, in factory-sealed packaging, at savings of up to 70 percent off what you would pay at the retail level.

17.   Chill out. Over 60 percent of doctor visits are for stress-related conditions. Studies show that relaxation techniques are effective in controlling anxiety, enhancing the immune system and reducing conditions such as high blood pressure, substance abuse and chronic pain.

18.   Quit smoking. On average, health care costs are $1,600 per year for a smoker. Plus, if you quit smoking you can expect to save approximately $1,800 a year on the cost of cigarettes alone.

19.   Live a healthy lifestyle. Focus on eating nutritiously, cutting down on fast food and getting more physical exercise. Striving toward a healthier lifestyle and maintaining a healthy weight can drastically reduce future medical conditions and diseases.

20.   Wash your hands. According to the Centers for Disease Control and Prevention, hand hygiene is the most important factor in preventing the spread of germs. In fact, health experts estimate that 80 percent of common infections are spread through hand contact. Save hundreds of dollars a year on cold and flu treatments.

21.   Get a second opinion. Save thousands of dollars a year on cutting-edge medical tests, which usually are not covered by insurance by following the guidelines recommended by the U.S. Preventive Services Task Force – www.ahrq.gov/clinic/uspstfix.htm.

22.   Think twice about the emergency room. Don’t ever go to the emergency room (ER) when your regular doctor or an urgent care visit would suffice. If you or your child is feeling ill on Friday, get into the doctor that day to avoid overpaying at the ER during the weekend.

Providing your employees with resources to help them understand the complex health care system and pricing can benefit your employer-sponsored health plan tremendously. The more educated we are, the smarter decisions we can make when it comes to health care. Wise health care consumerism not only leads to more money in your employee’s pocket, but also more savings for you, the employer. If you are looking for innovative ways to manage your group health costs, please contact us. We have several clients of all sizes who have experienced exceptional success in educating employees and managing costs through a health care price transparency tool we offer. We welcome the opportunity to discuss if this tool woud be right for you employees as well.

Live Well, Work Well – Back to School Edition

As summer winds down and the kids head back to school, we all make adjustments as we transition back to our “normal” routines. If you’re like most parents, you are probably just as stressed as your child about the start of a new school year, and we want to provide some practical ways to make the transition as smooth as possible for your family.

  • Re-establish routines – By setting a regular bedtime and mealtime for your children, you prepare them for the structured schedule they will need to follow at school. Begin the routine a few weeks in advance, so they are wide awake for breakfast on the first day of school.
  • Freeze a few dinners – Keep a couple of meals in your freezer for the first few weeks of school. This way you won’t have to stress about cooking and will have more time to spend with your kids.
  • Create a homework space – Designate and clear a special area where your children will be able to do their homework in peace. During the weeks leading up to school, consider offering crafts or projects they can do area to help them get used to working there.
  • Attend parent-teacher night – Take the time to visit with your children’s teachers so you know what to expect in the coming year.
  • Be enthusiastic – The best thing you can do for your children is to be excited about the new school year. When you are confident, your children will be confident, too.

While preparing your children for the first day of school can really help their transition, it is only part of the equation. Especially during the first few weeks, set aside time each night to talk about how your children are feeling about school and positively reinforce the experiences they’ve had—this will help your children adjust to their new grade.

As usual, as the kids head back to school, we also notice unwelcome germs coming home with them. Whether your children catch something from a friend at school, or you find yourself surrounded by co-workers with a cold, we have a few remendies for you and your loved ones. The best news – all of them can be found in your pantry, saving you money and time visiting the pharmacy. **As always, use your judgment when deciding whether or not to seek professional medical help.

Honey: A spoonful of this wonder-ingredient will not only help to ease a sore throat, but applying it directly to a minor burn and covering with a bandage can serve as an antibiotic and speed healing times.

Oatmeal: Not just a nutritious breakfast, oatmeal can be used to soothe a rash or irritated skin. Create a poultice by putting cooked, cooled oatmeal in a cotton cloth and applying to the affected area, or steep uncooked oatmeal in a warm bath to treat the entire body.

Toothpaste: The next time you or a loved one is stung by a bee, consider reaching for a tube of toothpaste. Just a dab of toothpaste on a bee sting can quickly relieve the irritation.

Baking soda: This versatile ingredient soothes sunburn when added to a lukewarm bath, relieves the itching from insect bites when added to a cool bath, and can relieve an upset stomach when half a teaspoon of it is dissolved in a glass of water.

Olive oil: This common cooking ingredient can soothe an earache for most adults. Put two to four drops of warm oil in your ear to lessen the pain until you can contact a medical professional.

Ginger: For hundreds of years, ginger has been used to combat nausea and upset stomachs. Simply steep a 1-inch slice of this root in hot water and drink to ease a bellyache.

As we head into fall, MedCon will be keeping you up to date on everything health-care related, so be sure to continue stopping by our blog. Please reach out to us should you have any questions.

Maximize Your FSA Before 2012

As the year end approaches, we want to offer some suggestions to you about how to effectively utilize the funds still remaining in your flexible spending account, or FSA. Unlike a health savings account, the funds in your FSA cannot be carried over to the next plan year, so it is best to use them before your current plan year expires.

1. There is a substantial list of eligible expenses that can be purchased with your FSA, or that could potentially qualify for reimbursement if you have already purchased these items. Please note, this is a sample of common items and is not a complete list. Please check with your FSA provider first for a complete list of eligible expenses.

  • Acne Treatment Proactive, Stidrex, Clean & Clear Eligible
  • Acupuncture
  • Ambulance
  • Bandages Elastic, Gauze Pads, Band Aids
  • Birth Control Pills
  • Birthing Classes
  • Blood Pressure Monitoring Devices
  • Carpal Tunnel Wrist Supports
  • Chiropractors
  • Co-Insurance Amounts
  • Contact Lenses, Materials & Equipment
  • Contraceptives
  • Co-Payments
  • Crowns, Dental
  • Crutches
  • Deductibles
  • Dental Care Toothache Relief, Temporary Filling, Denture Adhesives
  • Diabetic Supplies
  • Ear Care, Ear Drops, Ear Wax Removal
  • Egg Donor Fees
  • Eye Examinations
  • Fertility Treatments
  • Adhesive Pads, Band-Aids
  • First Aid Kits
  • Flu Shots
  • Gambling Problem Treatment
  • Genetic Testing
  • Guide Dog: Other Aid Animals
  • Hearing Aids & Its Batteries
  • Immunizations
  • Infertility Treatments
  • Insulin
  • Laser Eye Surgery LASIK
  • Medical Alert Bracelet or Necklace
  • Medical Records Charges
  • Mileage for Medical Appointment Expenses for Transportation Primarily for & Essential to Medical Care
  • Nasal Strips or Sprays
  • Nicotine Gum or Patches Nicoderm, Nicorrett Eligible
  • Occlusal Guards to Prevent Teeth Grinding
  • Oxygen
  • Sleep Aids Tylenol PM, Sominex, Unisom
  • Smoking Cessation Medications Patches, Gums
  • Stomach/Digestive Relief Pepto-Bismol, Imodium, Colace, Lactaid
  • Tooth & Mouth Pain Relief Oragel, Anbesol
  • Vitamins
  • Walkers
  • Wheelchair
  • X-ray Fees

2. If you have any receipts for health care related expenses or dependent care related expenses, be sure to submit them as soon as possible in order to be reimbursed. This will help you verify how much you have left in you FSA account.

3. If you regularly purchase medical supplies that are eligible to purchase with your FSA, you can stock up on them before your plan year expires with your leftover funds.

4. Make sure you and your family members are caught up on all doctor appointments. Your FSA funds can often be used toward your co-pay and coinsurance at your physician, dentist and optometrist, as well as some specialty doctors as long as they are listed on your eligible expenses list.

5. Make sure you and your family members are up to date on your vaccinations, including the flu shot.

6. As always, keeping up with your wellness is an essential step to keeping your medical expenses to a minimum. Weight loss counseling and methods to help you quit smoking are eligible expenses for your FSA, as long as you have a doctor’s note of medical necessity.

If you have questions about any of these items, please feel free to contact your health care experts at MedCon Benefit Systems Group, Inc. (214)739-5215.

Maximize Your Employee Benefits Program

With the economic recovery continuing to be slow and companies under pressure to overcome a number of challenges, the employee benefits landscape is continuing to change. Rising healthcare costs, new mandates of reform and economic influences are just some of the reasons employees are looking for solutions for the highest potential return on investment. Here are some tips from our benefit professionals on how to maximize your investments.
1. Work with a benefits  consultant / advisor who can help you design a “healthcare reform” strategy that includes a consumer directed approach with financial protection.
2. Get the best overall value and experience by partnering with those who can provide expertise and experience in delivering both self funded and employer funded benefits as well as voluntary benefits.
3. Engage your consultant to maximize the value of your benefits by meeting the financial protection needs of your various workforce diversities. Offer a range of benefit choices and include effective benefits education for your employees.
4. Optimize your ROI with helpful services such as employee assistance programs, helpful management of absences from FMLA and various state laws to streamlining HR time with benefits administration and technology solutions. Consider outsourcing services to our sister company, Employee Resource Administration, to help with all of your non-revenue producing functions.

Comparison Shopping For Medical Care

Have you ever wondered what it would be like if you could comparison shop for your medical costs?  When you go to buy a car, you spend $20,000 or $30,000, maybe even over $40,000.  The likelihood of you walking into the dealership and paying sticker without any questions is slim to nil. Yet, millions of Americans do just that with their healthcare every year.  Have you ever asked, “how much is the surgery going to cost?” or “how much exactly is the cat scan?”  Yet, these are procedures that can potentially cost upwards of tens of thousands of dollars and we have them performed at the directive of our physicians with no questions asked.
Once you have selected your insurance carrier and designed  your health plan, you hope the strength of the design is enough to deter over  utilization.  Employees are deciding where to go for treatment and surgery blindly.  Are they making the choice based on the cost to the employer’s insurance plan?  The answer is: not likely.  Consumers of health care services are not like most other consumers.  Employees do not, and in the past could not, compare prices before they bought.  In the past you could not find out a price for a diagnostic colonoscopy or a tonsilitomy.  Again, compare that decision to that of buying a car.
What if we could add to your program a service that allowed your employees to find out exactly what that cost would be up front?  Not only with one provider, but let’s say up to three?  How about if they compared three and then proceeded to schedule the appointment for your employees.  Imagine the time and money that could be saved.
If this is something of interest to you and your employees, contact us! We have the answers.
MedCon Benefit Systems Group, Inc.
214.739.5215