According to the Kaiser Family Foundation, one in four U.S. adults, including those with health insurance, struggle to pay their medical bills. Even more alarming, notes the Foundation, medical debt is the leading source of personal bankruptcy in the United States.
While rising health care costs are partially to blame for medical payment issues, high health care bills can sometimes be avoided through more informed health care shopping and decision-making. Unfortunately, most people don't think to shop for health care because they don't realize that health care prices can vary significantly amongst providers. And even for those who are aware of cost variations, they don't know how to attain or use the information needed to effectively comparison shop. As a result, they default to what they know, passively accepting whatever options are presented to them.
The New Year is always associated with opportunities to reclaim control – whether that's control over our time, our health or our finances. Individuals, and the employers they receive insurance from, can take control of all three through strategic use of health care transparency and advocacy tools.
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Resolution 1: Take control of time
As we know, most people are unaware of price discrepancies for the same service within the same network and even the same geographic area. These discrepancies can be significant – a knee replacement can cost anywhere from $33,000 to $101,000 – and yet, most patients do not comparison shop for elective procedures. For some, it doesn't occur to them to research their options; others don't even know where to begin and still others are turned off by the hours that comparison shopping might require.
And employees hoping that their HR department can provide guidance are likely out of luck. HIPAA concerns aside, with a mounting list of assignments, HR professionals generally have neither the time nor the skill set needed to investigate the most effective health care options for employees' specific needs.
HR teams can, however, enlist the help of health care transparency solutions and advocates. Transparency tools can quickly generate cost comparison reports for medical procedures and treatments, while advocates can talk employees through those options to answer their questions. As a result, individuals are better equipped to efficiently make health care decisions that benefit both them and their employers.
Resolution 2: Take control of health
Advocates can also ensure employees get the care they need by identifying providers within their network, researching specialists and helping to set up appointments for second opinions. Then, once employees and their family members have received the care they need, advocates can help make sense of the provider's instructions, provide more information about diagnoses and answer any questions the employee might have forgotten to ask—or been afraid to ask—during their visit.
Resolution 3: Take control of finances
Arguably the biggest benefit of transparency and advocacy tools is cost savings. By using transparency services, individuals can review cost comparison reports to identify price differences for the same service offered by different providers. They can then work with an advocate to discuss their options and choose whatever procedure or treatment gives them the best care at the lowest price.
While transparency tools help before care is received, advocates can help after the fact. Advocates can help break down and analyze costs woven into medical bill, and flag any unnecessary or overpriced charges. If necessary, they can help employees challenge and resolve incorrect health bills to ensure they only pay for the care they received – reducing costs for employees and employers alike.
This year, resolve to take back control of health care. By reclaiming control of time, health and finances, individuals and employers alike will feel good and be able to focus on other priorities.
Cheers to that!
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