By Shawn Wagoner, Senior Vice President of Surest, UnitedHealthcare
While technology has changed how we all shop for everything, from car rides to vacation rentals, health care quality and cost information has often remained elusive for many Virginians. In fact, research shows only a fraction of people were able to find the health care cost information they wanted, and 60% said they would like more information when deciding where to go to get care.
Improving access to health care quality and price information may help people save money and reduce the total cost of care. That’s because the cost for health care services at hospitals and doctors’ offices vary nationwide and within the same city, despite research showing higher-priced care does not necessarily deliver higher-quality care.
Consider these five strategies to help you more effectively comparison shop for health care:
Check with your health plan. Some hospitals and health plans are publicly disclosing cost information, including online. However, it may be difficult to decipher what you’ll pay for a visit or procedure if you’re only looking at online data, especially hospital pricing information that may not account for your health plan. Checking with your health plan is generally the better option, as some are making available estimates based on the member’s specific plan and actual contracted rates with care providers. For instance, millions of UnitedHealthcare members have access to health care quality and cost information for more than 800 common medical services across 600 episodes of care, providing a comprehensive view of what people should expect throughout the course of treatment.
Enroll in a plan with upfront pricing. Some newer health plans are moving away from estimates and instead offering upfront pricing, which enables members to review out-of-pocket expenses before medical care is delivered. Some of these plans use variable copays, rather than deductibles or coinsurance, which means the copay for the same service may vary depending on the care provider and facility you select. Through UnitedHealthcare’s Surest plan, a recent analysis showed out-of-pocket expenses for plan members were 46% less, while the cost for the company declined by up to 15%.
Select the right setting. When seeking nonemergency care, it’s important to always start with in-network health care professionals and facilities, as receiving care out of network may lead to an exorbitant charge. The type of facility you select can also have a significant impact on the cost. Receiving care at a hospital tends to be the costliest setting, while services at freestanding, ambulatory or same-day clinics typically cost less. For minor, nonemergency and some specialty services, a virtual care appointment may offer improved affordability and convenience.
Save on prescription medications. About half of Americans take at least one prescription medication, resulting in out-of-pocket expenses of more than $1,200 per year. For help to lower that, new resources are enabling people to compare available direct-to-consumer pricing for traditional generic drugs with insurance pricing to help individuals get the best available prescription drug price. Separately, care providers are gaining access to systems that enable them to identify which medications are covered by a patient’s health plan and the cost for each, offering suggestions for other clinically appropriate, lower-cost alternatives.
Negotiate surprise bills. Even with upfront research, there are still potential risks to be aware of. To ensure preventive services are indeed covered by your insurance, confirm with your health plan before receiving care. In the event of a surprise bill, some health plans offer access to resolution support to help negotiate on behalf of members. If you receive a surprise bill, call the number on your insurance ID card to alert your health plan and check on assistance.
Shawn Wagoner, Senior Vice President of Surest, UnitedHealthcare
