Insurance giant UnitedHealth Group compiled information about Dallas’ healthcare prices in an effort to make its clients aware of the range that exists and motivate them to act in their best interest. They found procedure costs that were five to ten times the lowest price in the area.
According to their data, MRIs can range from $240 to $3,290, while a C-Section can range from less than $4,000 to more than $11,000, and a lumbar fusion back surgery can range from under $23,000 to over $129,000. With such a large range, UnitedHealth thinks it is important for its clients to be informed.
So how are consumers supposed to shop? With the new year came legislation that forces hospitals to post their prices for all procedures and operations, but after insurance, reimbursement rates and an individual’s health needs are considered, the out-of-pocket costs might look nothing like the posted prices, if the prices can be interpreted at all.
Insurance companies have the incentive to get their health plan holders to choose cheaper options as well as the information patients need to make the right decision for them. UnitedHealth is the largest single health insurer in the country, and we spoke with Katherine Bisek, their Vice President of Strategic Initiatives, to learn more about a tool that provides transparency to their clients so they make the best choice for them.
Bisek has seen how understanding price range leads to action that will save the patient money. High deductible plans have made clients more price-conscious, and UnitedHealth has seen significant growth in the use of its transparency tools. Bisek says that the number of their health plan holders who have used the internet to compare costs has doubled since 2012, and in just the last year, there has been an increase from $5.5 to $13.7 billion worth of cost estimates on their site.
“Using the tool impacts their decision,” Bisek says. “We see a see greater usage of quality providers and reductions in total cost of care.”
Health plan holders can log in to the cost estimator and choose the procedure that they have been told they need, and see what their out-of-pocket costs would be at different providers after reimbursement rates, location, deductibles, copays and other information has been factored in. For the patients that use the estimator, they have seen a 36 percent reduction in healthcare costs. The tool also provides a guide to the different steps that are involved in different care pathways, as well as quality ratings for different providers.
Because 43 percent of the country is insured by their employer (who ends up paying for healthcare), Bisek has also seen private companies incentivizing their employees to shop around in order to reduce costs.
For Bisek, increased transparency is all about about taking awareness and moving to action. “It really is that journey of understanding the steps and what one can do about them,” Bisek says.
Hospitals have only needed to post their prices for a few weeks, but UnitedHealth has been using some form of this tool to provide transparency since 2005. “We as a health plan continue to evolve our tools,” Bisek says. “The more we make it easier to find information, the more you should use these tools to get the information you need.”
