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Many consumers will search for a coupon that saves them a dollar at the local supermarket, but when it comes to healthcare—a far more complex and expensive service—we rarely ask questions or consider all the options that could save us time and money. This behavior ultimately drives up the cost of health benefits for employers.
Imagine a world in which every American is a subject matter expert in the price and process of purchasing medical services. In this ideal healthcare system, each person actively shops around for medical services, comparing prices of services instead of going to just any facility or healthcare provider without giving it a second thought.
Encouraging your employees to become conscious healthcare consumers will ultimately improve patient outcomes and levels of satisfaction with the medical care they receive and reduce costs within the entire healthcare industry.
As an employer, if you want to help reduce employee health benefits costs for your business by encouraging your workforce to become more active participants in the process, you’ll need to set your employees up for success by providing the information and resources they need to make well-informed decisions.
Here are seven tips you can share with your employees to help them learn to shop for value when it comes to medical benefit decisions.
1. Use your bargaining power.
Don’t be afraid to negotiate with healthcare providers about the cost of services. More than 90% of people in the U.S. who've negotiated a medical bill have had that bill reduced.
2. Know the cost of care ahead of time.
You’ll be more prepared to negotiate discounts when you know the real costs of care. As of 2021, every hospital operating in the United States is required to provide clear, accessible pricing information online about the items and services they provide. You can also find rates for most services on your insurer’s website.
3. Shop around using price transparency tools.
When you make a purchase on Amazon, you probably do some comparative shopping by reading reviews and browsing for similar products that might be available for a cheaper price. Because the cost of a particular medical service can vary greatly depending on the provider—even from one in-network provider to the next—it’s smart to adopt similar habits of shopping around and comparing prices for medical services.
Despite this, a recent study found that only 3% of individuals who paid some out-of-pocket costs for their last health visit compared costs among providers.
Fortunately, the amount and quality of pricing information for healthcare services is growing through the use of price transparency tools.
According to Modern Healthcare, “Nearly all major health plans offer a cost-estimator tool or contract with a third-party vendor to provide one so that commercially insured patients can search for common clinical service and obtain a cost estimate. The vast majority of self-insured employers—85%—offer such tools to employees.”
4. Pay in cash.
You can routinely save up to 10% on your bill by paying in cash upfront, and often much more than that. Doctors lose thousands of dollars every year on credit card processing fees, unpaid bills, and collection fees.
According to Consumer Reports, “Healthcare providers, more doctors, hospital networks, and treatment centers are touting big discounts for patients who pay cash upfront.”
Reduced fees for cash payments are commonly used for diagnostic procedures, such as CAT scans, X-rays, and ultrasounds, but consumers who pay cash can also often get cheaper prices for certain lab work, prescription drugs, therapy services, and out-patient surgeries.
5. Audit your medical bills.
Be sure to review your medical bills in detail—insurance companies and billing offices often make mistakes. Keep a record of your appointments, tests, services, and medications, and compare them against your bills. If you find an error, request a corrected bill and notify your insurance company.
6. Take advantage of telehealth and telemedicine services.
Telehealth and telemedicine platforms utilize virtual technology to help physicians and patients communicate with each other, even if they are not in the same physical location. This communication can be either in real-time or delayed, via phone, webcam, or email. Telemedicine can be used for the evaluation, diagnosis, and treatment of patients. Certain providers, such as mental health professionals, may charge less for virtual visits.
7. Stay in-network.
Your medical costs can increase greatly when you visit a provider who is not in your plan’s network. Make sure your primary care doctor and any specialists you may need to see are in your network whenever possible.
Encouraging your employees to become more active participants in their healthcare journey will help set them up to receive the maximum value from their health benefits.
With the advent of consumer-driven health plans, encouraging your employees to effectively use their health benefits is more important than ever. Employers should provide outreach and education to the populations of interest, help with enrollment, and keep employees informed so they can make the best choices about how they spend their healthcare dollars.
Andrew Grove is Executive Vice President of Sales & Account Management for the Employee Benefits Consulting division. He leads several aspects of the division, including the management of the sales team and its resources. Andrew is a Licensed Health Insurance Counselor as well as a Licensed General Lines Agent—Life, Accident, Health, and HMO, and he has received numerous training certifications and awards.