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Collaborating to create something very powerful
Controlling your health care costs
Health Tips
New Price Transparency Tools
Tools for Consumers to Look-up Prices
A Little Self-Discipline
Disparities in the Cost (and sometimes Quality) of MRIs
How to Make the Most of Your Healthcare Dollars

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February, 2010 (5)
December, 2009 (3)
November, 2009 (1)
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August, 2009 (7)
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May, 2009 (7)
April, 2009 (10)
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The opinions expressed herein are my own personal opinions and do not represent my employer's view in any way.

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 Monday, March 30, 2009
Collaborating to create something very powerful
Monday, March 30, 2009 5:37:04 PM (Central Standard Time, UTC-06:00) ( Finding the Best Value for Health Care Services )

The original idea behind OutofPocket.com was to build a platform that would enable consumers to collaborate.  Consumers would use OutofPocket to post/share prices they paid for actual health care services.  This collaborative effort over time would result in a very powerful directory of true prices that consumers could use to find the best value and make the most of their health care dollars.

 

If enough consumers start shopping around for the best value (quality and price), providers would start competing for our attention and good things would result.  Competition and choice will:

·         Lower costs of health care services

·         Promote innovation

·         Expand choice

·         Increase access to medical care

·         Improve patient care

 

My challenge is getting people to participate in OutofPocket.com and start posting/sharing prices.   People respond to incentives.  Perhaps exposing health care prices and helping to create more competition and choice in the health care industry is not enough of an incentive.  If you give people more of a reason to do something, they will do more of it, and if you make it easier for people to do more of something they are already inclined to do, they will also do more of it.  Today health care costs are spiraling out of control; we have more than 47 million people that are uninsured and over 12 million people with consumer-driven health plans.  These combined 59 million Americans have every reason to make the most of their health care dollars and find the best value.   These people are financially rewarded if they make their health care dollars go further.  If I knew I could save myself $500 by shopping around for an affordable MRI in my neighborhood, I certainly would be financially motivated to take advantage of this savings.

 

If you know of one of these 59 million people – please let them know about OutofPocket.com.  Or even better, drop me a note info@outofpocket.com to let me know how I can help.   

 

Be Healthy,

Mona Lori

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 Sunday, March 29, 2009
Controlling your health care costs
Sunday, March 29, 2009 5:26:59 PM (Central Standard Time, UTC-06:00) ( Finding the Best Value for Health Care Services )

WebMD provides valuable health information for consumers.  A recent article by WebMD Health News writer, Miranda Hitti, provides useful tips on how you can spend less on health care services.  The article is a three-part series that covers topics on how to manage costs of children’s medical care, cutting prescription drug costs and reducing costs of doctor visits. Below are highlights of the article.

 

Children’s Medical Care

 

Children need lots of medical care for vaccinations, routine checkups, sniffles, sore throats and fevers.  Look into local and state resources that provide assistance based on financial need.  Check with your local state or local health department. Most of these agencies can refer you to affordable health care providers that offer sliding scale fees based on your income.

 

Don't skip children's vaccinations.  Kids and teens – and even adults, need to stay up to date with their immunizations.  Many retail clinics offer affordable vaccinations.  Local health departments offer health and wellness services through hospital community outreach programs, at affordable costs to the community.  Contact your village hall for more information.

 

You should first try to phone or email your pediatrician's office with basic questions. You can often avoid a costly trip to the emergency room by taking advantage of telephone counseling for many routine kinds of problems. 

 

Doctor Visits and Medical Tests

 

Skipping doctor appointments could be risky and you could end up spending more money later on for expensive emergency treatment or health consequences for more severe conditions.  Be sure to follow through with preventive care.

 

Take care of your health --- it’s your most important resource.  A healthy lifestyle can pay off – literally.  Your good health makes you wealthy.  Think about it, if you are healthy, you might need fewer prescription drugs, you might be less likely to develop high-maintenance conditions such as heart disease, diabetes, and high blood pressure.  Your insurance premiums might even be reduced.

 

Eat healthy foods, exercise, and lose the extra weight.  Even simple walks can make a huge difference in your overall health. Walking is free and you can walk anywhere!

 

Negotiate with your doctor, or the financial counselor at your doctor's office, about medical test costs and office visits.  If you are uninsured or have a high-deductible plan, providers will often provide you with a big discount (up to 70%) for paying cash at time of service.  If the discount they offer is not a fair price, offer to pay the Medicare rate (these rates are public information).

 

Research your local and state health resources.  Look into community health centers (which typically charge fees on a sliding scale), free clinics, and local or state programs for children.  A community center charges as little as $20 for what an urgent care center will charge around $110 and most doctors’ office charges $120.  You can save a lot of money by being a savvy consumer.   If you have children and meet certain income standards, check with your state or local health department about insurance.

 

If you are uninsured, investigate what coverage you may be eligible for, that you might not know about.

 

Don't use the emergency room for problems that aren't emergencies.  Because emergency rooms are overwhelmed, you may wait hours to be seen. And if you're paying out-of-pocket, you could wind up with a very expensive bill, which you will be responsible for.

 

Prescription Drug Costs

 

Ask your doctor about generic drugs and over-the-counter drugs.  Many people respond as well from generic drugs as on brand-name drugs.  Generic drugs are a lot more affordable.   Be sure to ask your doctor if you can get higher-dose pills to cut in half because high and low doses of drugs often cost the same amount.  Cutting your pills in half not only makes your pills last longer, but you can save a lot of money.  For instance, a patient who takes 20-milligram doses each day of a drug that costs $100 per month could save $600 a year if his doctor prescribes a 40-milligram dose and the patient cuts each pill in half.   Be aware that some pills don’t work properly if they are split so ask your doctor or pharmacist.

 

Shop around and compare costs for the best price on your prescription drugs.  The cost of your prescription drugs may vary a great deal across different pharmacies.

 

Look into drug companies' assistance programs.  Drug companies offer assistance programs to help cover medication costs for people who meet certain financial criteria.

 

Consider your Medicare Part D plan.  If you're 65 or older, or have Medicare because of a disability, you can switch Medicare Part D plans each year from Nov. 15 through Dec. 31, so you may want to assess whether your current plan is still the best deal for you.

 

Store your pills correctly.  Heat, moisture, and darkness can reduce the potency of the medication.  You spend a lot of money on your prescription drugs so be careful how you store them to avoid waste.

 

Be careful with promotions for expensive drugs. If your doctor gives you a card offering a one-time deal on an expensive prescription drug, you might want to remember that that deal won't help you if you refill that prescription.  Keep in mind that you are going to have to pay for the refill out-of-pocket.

 

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 Thursday, March 19, 2009
Health Tips
Thursday, March 19, 2009 1:43:25 PM (Central Standard Time, UTC-06:00) ( Consumer-driven health care )
Reducing health care expenses involves much more than simply finding the best value for services.  Everyone knows that eating healthier and exercising more can improve your health.  Maintaining good health goes a long way and here are some practical tips, in addition to eating healthy and exercising every day, that are guaranteed to improve your overall health.   These tips are easy to follow, cost nothing and you can start following these tips today to make a big difference.
  • Drink more water
  • Eat breakfast every day and try to include protein and fiber
  • Increase your fiber intake
  • Eat more fruits and vegetables.  Remember to eat a variety of colorful fruits & vegetables (red, orange, green, yellow and purple)
  • Get at least seven hours of sleep a night
  • Floss your teeth every day
  • Find your spiritual self
  • Develop a supportive network of friends
  • Stop drinking soda
  • Smile more often
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 Monday, March 09, 2009
New Price Transparency Tools
Monday, March 09, 2009 4:19:42 PM (Central Standard Time, UTC-06:00) ( Consumer-driven health care | Finding the Best Value for Health Care Services | Transparency )

Two new websites that promote price transparency were recently announced, New Choice Health and Leslie’s List.   Transparency tools enable consumers to make informed choices before purchasing medical services.  I am always thrilled to discover new transparency tools consumers can use and you should definitely check out both of these websites. 

 

Keep in mind that these websites provide estimates /average prices for services.  Health care pricing is very complicated and it’s difficult for consumers to know what their actual out-of-pocket expenses are in advance.  Determining actual out-of-pocket costs requires knowledge of fee schedules, contracted prices, and understanding details of different insurance plans including coinsurance, deductibles, co-pays.  Wouldn’t it be nice to be able to easily look this information up online?  How many people do you know that would purchase electronics or a vacation package knowing the “average” price, rather than the “true price?”

 

Both of these websites are worth checking out.

 

Leslie’s List ---  a brand new web site to help consumers find the best price on prescription medicines, medical testing and other healthcare services in the Chicago area.  This site is a gold mine of affordable providers in the Chicago area and targets consumers that are uninsured or underinsured. The founder is a physician practicing internal medicine in Chicago, Illinois.  Her mission is to provide information that enables all patients, especially the uninsured and underinsured, to find more affordable medications and health care services.  The site claims to provide accurate and up-to-date information but they also recommend you call and confirm all information before visiting a provider

 

NewChoiceHealth -- is a medical cost comparison site I discovered thanks to the OutofPocket champions that alerted me to this new tool.  The interface is extremely well done and the information is very easy to find.  According to the founder, the website includes estimates of the cost of medical services for an insured consumer based on “past claims experience, fee schedules and how the large insurers generally negotiate prices with providers.”  Consumers may be able to negotiate lower, or be charged higher, rates based upon their particular circumstances.  New Choice Health hopes to educate consumers about the wide-range of prices for health care services, so they realize that they need to shop before they purchase.  They are empowering consumers with medical cost knowledge, enabling them to make more informed healthcare purchasing decisions.  The site provides “estimates” or “average prices” so before you visit one of the providers listed on this site, make sure you call to confirm all information before you visit the provider. 

 

 

 

 

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 Thursday, March 05, 2009
Tools for Consumers to Look-up Prices
Thursday, March 05, 2009 11:34:07 AM (Central Standard Time, UTC-06:00) ( Consumer-driven health care | Transparency )

Over the past few years, I have researched most the price transparency tools that are available to consumers.  Some of these tools can be accessed only by members of health insurance plans.  Some tools require a subscription or fee to access the pricing report data.  There are many other free tools that enable consumers to look-up prices of health care services.

 

Here is a short list of free public tools that consumers can use to look-up price of health care services.  If you would like the list of URLs to access these tools, please send us an email info@outofpocket.com

  • AMA CPT Online
  • Carol
  • Cost Helper
  • DoctorPricing
  • Healthcare Blue Book
  • Health Pricer
  • LesliesList.org
  • MainStreetMedica
  • MyHealthScore
  • New Choice Health
  • OutofPocket
  • Spectrum Health
  • State Hospital Websites
  • USA Healthcare Costs
  • Vimo

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 Wednesday, March 04, 2009
A Little Self-Discipline
Wednesday, March 04, 2009 5:35:43 PM (Central Standard Time, UTC-06:00) ( Consumer-driven health care | High deductible Health Insurance )
Consumers with health insurance plans that have low-deductibles and low co-payments have absolutely no motivation to shop around for the best value or compare prices before visiting a provider for even the most routine type of services (MRIs, x-rays, mammograms, lab tests, dental and vision).   They purchase health care services from whomever, regardless of price or quality of service.  They visit emergency rooms for non-emergency conditions because “it only cost $75 co-pay for a visit to the ER.”  They often overuse medical services, have an unnecessary number of diagnostic tests performed, and fill every prescription a doctor prescribes without questioning generic alternatives.  These consumers are not concerned about the true cost of health care services.

When consumers have high-deductible health plans, they are rewarded financially for making good choices.  Spending health care dollars is spending their own money so they are interested in making cost-effective choices.  Everything changes.  People become responsible about their health and their health care costs, and expenditures drop like a rock.

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Disparities in the Cost (and sometimes Quality) of MRIs
Wednesday, March 04, 2009 2:06:02 PM (Central Standard Time, UTC-06:00) ( Consumer-driven health care | Finding the Best Value for Health Care Services | Transparency )

Healthcare Prices:  Looking Behind the Curtain is a new blog that you should follow. Jeffrey Rice, CEO, HealthCare Blue Book, covers healthcare transparency news and discusses issues that you will find interesting.  His recent post discusses the disparities in health care pricing and how paying more doesn’t always mean better quality.  The fact is that the price for an MRI can range from $500-$2500 in the same geographic area.  Let’s take a look at some of the real out-of-pocket savings when consumers choose a provider that charges $500 for an MRI, rather than the provider that charges $2500 for the exact same diagnostic test.

  • An individual with a co-pay would save $100 out-of-pocket by selecting the $500 MRI , rather than using the $2500 provider
  • An individual with a high-deductible would save $2000 by selecting the $500 MRI
  • Employers that are self-insured would save ½ million dollars a year just on MRIs of the knee, if they encouraged employees to use the cost-effective provider that charges $500 for their MRI.
  • Total dollar amount of claims would be reduced, and this could result in lower premiums
  • Just imagine how much $$$$ insurers would save if consumers adopted cost-effective behavior 

One of the greatest challenges in getting people to use cost-effective providers is how do we encourage and enforce this cost-effective behavior?  One of the few unquestionable principles of economics is that people respond to incentives.  If you give people more of a reason to do something, they will do more of it.  If you make it easier to do more of something they are already inclined to do, they will also do more of it.  Reducing my out-of-pocket expenses is enough of a reason for me to select the provider that offers the best value. 

 

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 Tuesday, March 03, 2009
How to Make the Most of Your Healthcare Dollars
Tuesday, March 03, 2009 9:17:17 AM (Central Standard Time, UTC-06:00) ( Consumer-driven health care )
The cost of medical care is rising by the day, and it’s becoming harder to stretch your dollars to meet medical expenses, especially if they occur on a regular basis. Even if you have health insurance, it’s important to spend your out-of-pocket dollars wisely. If you’re wise and careful enough, it’s easy to make the most of your healthcare dollars, by:

  • Preventing illnesses by following routine precautions and basic cleanliness.
  • Adhering to a healthy lifestyle – not smoking and drinking, eating healthy food, exercising regularly, drinking enough water, and keeping your mind relaxed and stress-free.
  • Preventing accidents and keeping your home safe from potential hazards.
  • Following safety precautions and road rules to avoid meeting with accidents that could prove to be extremely costly affairs.
  • Getting yourself checked routinely to identify potential health risks.
  • Understanding your illness, if you have one, its conditions and implications, and making an informed decision about the best treatment.
  • Opting for treatment before conditions become serious and hence more expensive.
  • Taking the medication that’s prescribed for you – some people stop taking them when they begin to feel better, but it’s imperative that you finish the course your doctor has prescribed.
  • Reviewing your medication on a regular basis (if you have a chronic condition like diabetes) and ensuring that you’re not taking any that are not necessary.
  • Asking questions about medication to ensure that they’re necessary and to know what they treat.
  • Switch to generic drugs that are as effective but not as costly as the branded ones.
  • Asking relevant questions about any prescribed diagnostic tests to ensure that they are absolutely necessary.
  • Understanding the benefits you are entitled to under your insurance plan.
  • Planning ahead for pregnancies and other medical routines that can be put off.

It’s a well know fact that health is wealth, and it’s absolutely imperative that we’re physically and mentally fit if we’re to enjoy and savor life. It’s also true that prevention is better than cure, so do your best to prevent diseases before they catch you. And if you still fall sick, make sure you do all it takes to get better soon rather than spend unnecessary time and money at the doctor’s office.

  

This article is contributed by Sarah Scrafford, who regularly writes on the topic of online pharmacy technician training. She invites your questions, comments and freelancing job inquiries at her email address: sarah.scrafford25@gmail.com.

 

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