Online tools to help shop for the most affordable health care

by Ray Carlson

Two recent articles posted here at KevinMD.com regarding the inclusion of discussions about the cost of health care services between doctor and patient highlighted the growing emphasis on not only the quality of care but the cost of that care to the patient as well. The first article was written by Dr. Leslie Ramirez, who advocated for a more proactive stance by doctors regarding the subject of costs in order to gauge patients’ ability to pay for the drugs/procedures that had been prescribed or ordered by the doctor. The second article – written by Dennis Grace, medical billing advocate – likewise advocated for the inclusion of ‘cost of care’ discussions in the interaction between doctor and patient.

In reading both articles and the reader comments each generated, it seemed that readers from both within and from outside the medical system might be unaware that insurance carriers are being proactive in providing members with online health care buying tools or payment estimators that will help make for more savvy health care consumers. These cost comparison tools are just a part of the many value-added member benefits provided by carriers: Other benefits include important health and wellness tools that can help a member start or continue a healthy living lifestyle initiative. (These wellness tools dovetail nicely with the mandate for extensive free preventive services for plan members thanks to Health Reform legislation and its emphasis on prevention to ward off later, more costly health issues.)

Online tools that help insurance plan members shop for the most affordable health care services can be especially beneficial to members who have high deductible health plans (like HSA-compatible health plans) that require plan members to be more proactive in deciding how they want to spend their health care dollars. High deductible equals more affordable premiums and the move is towards more of this type of plan structure to serve consumers across the country who need health coverage at budget-friendly prices.

While each carrier has their own unique approach to how they promote cost comparison tools to their members, the effort to promote the use of this important consumer tool is there. On the other hand, for any number of reasons, patients may very well forget about the existence of an online cost comparison tool; especially when their focus and concern is rightly on getting healthy again. Also – as any casual reader of KevinMD.com can attest – stories about a doctor’s typical day really drive home the fact that patient care and the practice of medicine itself is uppermost in the doctor’s mind during the course of the day and it’s understandable that cost of care can often times fall by the wayside as the patient moves through the system and the average doctor is looking to optimize the efficiencies to be found in every moment of his busy day.

Here’s where a doctor’s office staff can really be a great asset to the doctor’s practice and the patient. A proactive review of the patient’s insurance coverage and a simple bookmark in the Web browser of an office computer can be used to show a patient an online cost comparison tool, accompanied by a comment along the lines of:  “We see you have insurance from Company X. Did you know they offer this convenient online cost comparison tool to help you shop for the procedure ordered by the doctor? If you’d like; we can send you the link.”

As an in-network health care provider, the doctor’s practice is presumably a strategic partner to the business of the health insurer’s in delivering affordable health care to the patient. Working together, these two components of our health care delivery system can help protect the patient’s health and wallet. While it may not be reasonable to ask doctors to also be financial advisors, it does seem reasonable to ask that a part of that doctor’s business devote itself to helping patients – and health plan members – find the greatest value for their health care dollar.

Ray Carlson is a California health insurance agent and owner of California health insurance agency Vitality Health Insurance Services.

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  • imdoc

    “As an in-network health care provider, the doctor’s practice is presumably a strategic partner to the business of the health insurer’s in delivering affordable health care to the patient.”

    That is the supposition from the insurer side. The contracts are more like a software agreement – one can’t change a word of it, just ‘click here’. Doctors are in a vendor role to insurance companies. They negotiate for rates and except in capitation schemes, the financial success of the plan is not in their interest.
    There are many companies which will not publish what they pay for services due to proprietary concerns. Why? Well, how would they otherwise sell benefits managers on value? The role of insurance as a re-pricer is a critical component in the business model.
    I propose the following: the patient and insurer can partner on affordability schemes. Free up the regulations to permit doctors and hospitals to post prices. Patients can turn in bills to the insurance company and they in turn can bottom fish the market to reimburse the patient the lowest price. Now the incentives are aligned.

  • http://acowatch.com Gregg Masters

    Another emerging ‘Priceline equivalent’ for medicine option is FairCareMD.com.

    Whether sporting a high deductible health plan, or un-insured, it’s seems to be a platform that engages buyers (patients) direct with the sellers (providers) of health care services – both physician and hospital.