From Associated Financial Group’s Update

In 2012, the renowned political newspaper The Hill was blogging about one of the best ways “businesses and employees can lower their health care costs without sacrificing quality of care.” The solution, according to “Congress Blog,” is “price and quality transparency.”

Health plan participants often do not know price and quality before they purchase a medical service, such as a colonoscopy or X-ray. This lack of transparency has resulted in large price variations for medical procedures between providers.

“Huge variations in price for medical services can exist even within a single health plan,” says Jon Heidorn, CEBS, Benefit Consultant and Senior Vice President, Associated Financial Group. “So, many employees pay unnecessary health costs or even go without care altogether simply because they don’t know about more cost-effective options.”

What’s in it for you?
Transparency creates pricing pressures that benefit employers as well as employees and other plan participants by driving costs down.

“This happens in several ways,” Heidorn says. “When health care consumers begin to learn where to receive a high-quality and cost-effective colonoscopy or X-ray, they will start using that health care provider and stop using more costly providers. So, the more costly providers will be pressured to drop their pricing or ultimately go out of business.”

Prescription medication illustrates this point. In previous years, drug costs had been increasing at 18 percent a year— now drug spending is actually increasing at a slower rate than overall health care spending. “Transparency is a big reason why we’ve moved to generics and to lower prices,” Heidorn says. “With greater transparency, the rest of the health care industry may see the same progress.”

Value-driven health care resource
“There is a nationwide trend towards proving health care consumers with costs and quality information about local medical services and procedures,” says Heidorn. Specifically, the value-driven health care resources in the Midwest include:

  • UnitedHealthcare’s myHealthcare cost estimator: UnitedHealthcare offers an integrated online service that brings a retails shopping experience to health care and helps consumers find qualify care while being able to estimate the cost of more than 100 common treatments and procedures with maximum accuracy. Estimates are personalized to reflect an individual’s own health plan benefits, including their real-time account balances when applicable. Quality and cost information is directly connected to in-network hospitals and physicians, and alternate treatment options are provided so consumers can have an informed conversation with their physicians.
  • myHealthPartners.com: HealthPartners provides tools and resources for members for both quality and cost comparisons, including the ability to:
    • Compare providers based on cost for common conditions, treatments and services.
    • Compare providers based on quality scores.
    • Look up health care costs.
    • Learn how to reduce health care costs (cost saving tips).

“It’s important to collaborate with medical service providers when using cost and quality estimators,” Heidorn says. “This will provide a better overall patient experience while giving an accurate idea of expected costs and treatment options.”

Value-driven health care just makes sense
As health care organizations face a drive toward transparency, quality and cost data are becoming available in many formats. Call Associated Financial Group at 800-258-3190 or send us an email at info@AssociatedFinancialGroup.com for more information.

Jon Heidorn, CEBS, Benefit Consultant, Associated Financial Group. Heidorn has 28 years of experience in the employee benefits and risk finance fields. He has consistently and creatively solving problems for organizations, their employees, staff and other