By Rose Bennett Gilbert
Photo: Courtesy York Wallcoverings
Many women spend hours clipping coupons, going to multiple grocery stores or making sure they get the best price per gallon of gas. They would never fill up the tank of their car not knowing if they were spending $3 or $30 for a gallon of gas. Yet these same conscientious consumers have no idea what they are spending when one of their family members has a medical procedure, imaging test or surgery—even though the stakes are much higher!
It is estimated that the patient now pays 37 percent of healthcare costs. High deductibles of $1,000 or more are now a part of a third of all private health insurance plans and expected to increase as employers and patients try to control healthcare insurance costs. Many patients, in spite of healthcare reform, are still uninsured or underinsured. Healthcare expenses are the number one cause of bankruptcy, even for patients with health insurance. So how do we employ our skills honed from shopping for groceries and the best sales to lowering our healthcare costs?
Preventive care: certain prevention services are now mandated by the Accountable Care Act to be in your health insurance plan and are not charged to you and do not fall under your deductible. (www.healthcare.gov/what-are-my-preventive-care-benefits).
Medications: Generics save. Many older medications are as effective as newer ones. Ask your physician if there are generic alternatives to your expensive medications.
Outpatient services: Procedures such as colonoscopy, imaging such as CT and MRI and surgeries are almost always less expensive, with the same or better quality, when performed in an outpatient facility or imaging center (www.consumerreports.org/cro/magazine/2012/07/that-ct-scan-costs-how-much/index.htm).
Costs may vary even between in-network providers. For example, the price of a surgery procedure may vary between in network hospitals. This can vary with location, urban versus rural, inpatient versus outpatient. An outpatient service billed under a hospital tax ID may cost more than an independent facility. A short drive may save you big bucks.
Make sure all services are included when requesting prices. A facility may be in-network but the physician rendering the service may not. For example, a hospital is in-network but the anesthesiologist is not.
To compare apples and apples, know the difference between technical/professional and global billing. When an MRI is performed at a hospital, the hospital bills for the test being performed and the radiologist bills to interpret the study. Thus, you receive two bills. You need to know both fees. A single, global bill is the norm in an outpatient center and includes both the cost of the procedure and the radiologist’s interpretation. Be sure to ask, either way.
Compare prices: It is ok to ask. You are the consumer. The simplest is to request the self-pay fee schedule. Price transparency is becoming more available with sites such as Healthcare Bluebook (http://www.healthcarebluebook.com).
Choose a Healthy Lifestyle: Families who eat healthy foods, focusing on daily fruits and vegetables, exercise regularly and do not smoke have lower healthcare costs.
Open a Health Savings Account (HSA): Decrease your taxes and be prepared to cover your healthcare expenses.
Educate and empower yourself: Patients who are involved in their own healthcare will improve the outcome, raise quality and lower costs.
Resources to consider:
Patricia Shapiro, M.D. is a Board Certified Radiologist and Medical Director at SouthCoast Health Imaging, with offices in Hilton Head, Savannah and Richmond Hill.