HealthMarket

somarco

GA Medicare Expert
5000 Post Club
36,486
Atlanta
From a press release . . .

More than 70 percent of U.S. consumers say they know little or nothing about how much their doctors charge compared to other doctors, according to a survey sponsored by HealthMarkets, a leading provider of affordable health and life insurance to individuals, the self-employed and small businesses.

When it comes to Americans estimating the cost of health care, usually, the price is wrong – because the estimate is too low. Most adults (65 percent) think that, in general, a high-priced doctor in the U.S. charges two or three times as much for the same procedure as a low-priced doctor. In fact, a review of HealthMarkets data for several selected procedures shows that some doctors charge nearly 10 times what others charge for the same procedure.

“Most Americans have no idea how much health care costs or how much it varies from one provider to another,” HealthMarkets President and CEO William J. Gedwed said. “If consumers are going to effectively manage their health care dollars, they need to know how much things will cost them.”

The survey found few people have a sense of how much health care can cost, or how much costs can vary from one doctor to another. For example:

-- Told that the lowest price charged nationwide for a CT scan of the abdomen was $298, most people (73 percent) said the highest price other doctors charge for the same procedure would be no more than $2,000. (The low price was based on actual 2005 HealthMarkets claims data.)

-- In fact, the actual charge for the same CT scan varied from $298 to $2,858 - or almost 10 times as much as the low price - according to HealthMarkets 2005 claims data.

-- Told that the lowest price charged for a knee replacement was $22,000, 83 percent said the highest price was no more than $66,000.

-- In fact, the actual price charged for a knee replacement varied from $22,000 to $77,239, or more than three times as much as the low price.

-- Only 1 out of 10 respondents correctly guessed the high price range for a tonsillectomy.

-- The low price charged was $2,300. The high was nearly six times as much, or $13,187.

-- Even the price charged for a new patient office visit can vary greatly, ranging from $60 to more than four times as much, or $261, HealthMarkets data shows.

The survey found strong demand for tools that provide greater transparency for health care services. Almost 70 percent of people said it would be useful to have online data comparing health care providers.

Roy Ramthun, a former senior health policy advisor at the White House, said a lack of price transparency is one reason health care costs rise faster than inflation year after year.

“As consumers watch health care costs rise, they are eager to take more control over their health care decisions and spending,” Ramthun said. “Fortunately, some companies, such as HealthMarkets, are making great strides in helping consumers shop wisely for health care.”

HealthMarkets offers price and quality transparency tools that provide members detailed information on more than 430,000 medical professionals, 4,000 hospitals and medical centers, and 26,000 other resources, such as labs, MRI centers, medical equipment providers and home health care centers. HealthMarkets tools also provide price transparency for more than 20,000 procedures and services, from a routine check-up to a specialist visit to a surgical procedure. No other insurance company offers more price transparency information.

The tools, offered in the companyÂ’s CareOne Select Plans, are being rolled out nationwide and currently are sold in Alabama, Arizona, Georgia, Illinois, Michigan, Missouri, Mississippi and Texas. They are sold by HealthMarkets subsidiaries The MEGA Life and Health Insurance Company and Mid-West National Life Insurance Company of Tennessee.

Other findings of the survey include:

-- Close to 60 percent of consumers surveyed said that health insurance is not affordable. In fact, more than one out of 10 Americans (13 percent) said the high cost of health care had caused them to fall behind on paying bills for essentials such as food, electricity and housing.

-- A quarter of Americans (24 percent) said during the past two years they have skipped a visit to the doctor for a check up or medical problem because the amount they would have to pay is too high.

-- Among those who are self-employed or work in small business, nearly a third (31 percent) said they have delayed a doctor visit because out-of-pocket costs would be too high.

“Health care is taking a bigger and bigger bite out of family budgets, forcing people to make very difficult decisions,” Gedwed said. “We are committed to making health care as affordable as possible, and price transparency is one step in the right direction. We know that when consumers have better information, they become more prudent health care shoppers.” www.healthmarkets.com
 
If they were really concerned with "transparency", they would show how much of the bill "they" cover. This article looks like it was released by their PR dept.

I think John pointed out once that there is a hugh difference in the cost of a procedure done at the Mayo Clinic vs the same one done at "Any city" general hospital.
 
Transparency means nothing unless you can somehow create a system that consumers can judge quality of care. I doubt that many of the general population don't understand the price is higher at a Mayo Clinic Vs General Hospital. What they are truly in the dark over is the true sense of being able to judge Quality of Health Care between the two.
 
Oh I am certain this is from their PR dept. None of the information is surprising, but it is interesting none the less.
 
If Healthmarkets wants to take that road then whenever an agent tries to sell a R&B plan they should also show the clients the average R&B rate in that state. Don't think that's gonna happen. Maybe when Healthmarket agents sell a plan that caps chemo they can show the client a chart that shows the low and high cost of chemo. Then let's see how many plans they sell.
 
Yesterday

I replaced another Midwest plan yesterday, and I couldn't believe my eyes!

The agent sold her a $300 R & B max benefit!! OMG!! I told her it is 5x that here in Colorado! She bought it 2 years ago, I'm sure it's gone up that much since then!

But hey give the Midwest agent credit, he set her stop loss at 75K!! LOL!!

She also told me she tried calling her agent, who told her quote, "I don't deal with policy customer service issues, you need to call the company for that!"

Sometimes I feel bad for consumers!
 
Re: Yesterday

K-Dub said:
She also told me she tried calling her agent, who told her quote, "I don't deal with policy customer service issues, you need to call the company for that!"

Sometimes I feel bad for consumers!

As an agent exactly what kind of problems can you help her with?
 
Re: Yesterday

James said:
As an agent exactly what kind of problems can you help her with?

I do it all the time....from getting claims resubmitted to advising on policy changes....
 
Re: Yesterday

James said:
K-Dub said:
She also told me she tried calling her agent, who told her quote, "I don't deal with policy customer service issues, you need to call the company for that!"

Sometimes I feel bad for consumers!

As an agent exactly what kind of problems can you help her with?

I had a client who had a claim denied a few weeks ago. She had a rider for excema. No problem. But she went to the doctor for allergies which was fully covered. While at the office the doctor merely ASKED her how her excema was doing and she said fine. When he submitted the bill however he put the diagnostic code for excema. Maybe it was a mistake and maybe the doctor got paid more. Who knows. Anyway, I had my client call the doctor to get the records for that visit faxed - which proved the actual visit was for allergies. I faxed that to the company who paid the claim.

That's what you can do.
 
Back
Top