Can choosing care at one facility over another really make that much of a difference savings-wise for health plans?
Oct 19, 2016
2 min read
It can and it does. In the self-funded world, I hear people make reference to general examples quite often, but sitting in on a presentation at Cypress University delivered by one of our partner firms, Akeso Care Management, was an eye-opener. We saw a series of actual cases and the comparisons for each in terms of price by facility, savings to the health plans and ROI.
To give you some background on Akeso, the company serves as a “medical concierge” in the services they offer. I feel this is a concept that makes great sense for consumers today and really produces results when considering total dollars saved.
Think of how a hotel concierge works. People seek out these individuals for recommendations on/reservations for the best restaurants or attractions because they know the ins and outs of a certain area. This is similar to how a medical concierge operates, just swap out the restaurants and attractions for medical care.
Here’s one example Akeso shared with us. A patient was set to have shoulder surgery at an acute care facility. It would have cost $55,500. The individual then learned that the same procedure could be performed at a freestanding surgery center for $15,227. One intervention like that meant $40,000 in savings to the health plan!
The great thing about being able to compare options is that plan participants are getting the inside scoop on where they can receive both high-quality care and cost-effective prices. They might initially assume that a procedure at a nearby hospital will cost the same as it would at an imaging center just outside of town. The reality is that the costs for both could be completely different and your health plan could really benefit when members know all of their options and take the time to weigh them.