Every day consumers make important decisions that affect their family’s health and health-related financial security. Making these choices can be stressful and overwhelming, especially if a family member is ill or considerable medical expenses are involved. Often, it may seem like you don’t have a choice when faced with the cost of medical procedures, but that is not always the case. Many consumers today are taking more responsibility for their health care, which includes seeking more information about the cost of health services and making informed decisions regarding their care. This movement is called consumer-driven health care.
Comparison Shopping
Consumer-driven health care, or consumerism, revolves around the idea that consumers should be able to make informed choices about their medical care based on price and quality information. The eventual goal is for well-informed health care consumers to compare prices—choosing more wisely and ultimately lowering overall health care costs for everyone. However, the apples-to-apples comparison used for most products or services is mostly useless in the health care marketplace.
To date, lawmakers and health insurance companies have placed a great deal of emphasis on developing consumer-driven insurance products, but price transparency, an important aspect, has been mostly overlooked. Generally, the prices of health care services are not made public, making comparison shopping seem impossible. For realistic comparison shopping between hospitals, for example, you need to know in advance what the bottom line price would be for an all-inclusive bill, including hospital and physician fees. However, it’s hard to hunt for bargains when the prices of various tests, treatments and procedures differ significantly depending on a variety of factors, such as the type of health insurance you have, whether you have surgery at a hospital or freestanding surgery center, and whether your surgeon or anesthesiologist participates in your health plan’s network.
The goal of price transparency in health care is to help buyers have an easier time determining which providers have the lowest prices. Good information on provider quality is also important, so consumers aren’t compelled to simply choose the “cheapest” alternative, but rather make choices that provide the best quality health care for the best value.
Unfortunately, true price transparency—where consumers have realistic information about provider cost and quality at their fingertips—is scarce. However, the growth of consumerism in health care and the growing prevalence of HSAs as an integral part of employer-sponsored health benefits are likely to put pressure on hospitals, physicians and other health care providers to make their prices more readily available.
MedCon has successfully introduced a patient advocacy program to many of our clients of all sizes. With just a phone call, your employees are connected to an account representative assigned to your company who knows all the details of your health plan. Your account representative will search for board certified, in-network physicians in your employee’s area and send them a list of options to choose from. They will even set the appointment for your employee and review EOBs or assist with claim disputes.
This is a true health care concierge service and MedCon is excited to offer this tool to our clients. Please contact us today for more details about this program.
Medcon Benefit Systems Group, Inc. 