Study: Shift from highest-priced healthcare providers would generate tremendous savings.
Consumers in just a single Massachusetts county may have saved almost $22 million in a single 12 months and $116. 6 million adjusted after inflation over 4 years if they switched from using the most expensive suppliers for 16 healthcare services to plans with rates that were closer to average, according to a study published by Pioneer Institute.
Healthcare costs can vary significantly throughout Massachusetts, and more expensive care doesn’t generally mean better quality. The Healthcare industry is the only one where consumers are unaware of the overall price and the total out of pocket cost for a service/procedure when they need it. The insured policyholder is usually only aware of their co-pay and deductible.
“Greater utilization of lower-cost/high-value providers would save money for consumers, carriers and reduce overall healthcare costs” said Pioneer Executive Director Jim Stergios.
Under Massachusetts law, all providers, including doctors, hospitals, dentists, and clinics, are required to give consumer price information within two days of request. Insurance Carriers are required to provide members with recent out-of-pocket cost information, overall price information, and how much remains of their deductible through a 1-800 number, and in real time through a cost estimator tool. Most Massachusetts policyholders don’t know they have the right to this information.
What usually happens is the insured party attempts to get prices and costs from their providers are met with frustrating obstacles, including numerous transfers between extensions, long wait times, and messages not returned. While carriers are mostly in compliance with state law and improved their cost estimator tools, less than a third of their policyholders are aware that these tools exist, and very few have tried to use them.
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