Healthcare Cost and Quality Changes Based on Where You Are

Location, location, location. That saying is ubiquitous in the real estate industry but could just as easily be applied to healthcare. Why? Because two variables critical to healthcare decision making, cost and quality, are largely determined by where the care is delivered.  The cost of a knee-replacement surgery, for instance, varies widely across the nation. According to the National Chartbook on Health Care Prices published by the Health Care Cost Institute, the average cost for a knee… Read More →

Why Network-based Healthcare Costs Are a Major Consumer Vulnerability

A Texas schoolteacher was in his own city, in his own home, when he had a heart attack in 2017. Yet when he returned home after a successful surgery, his health insurance company said that he owed them $108,951 — all because the neighbor who rescued him happened to take him to a nearby hospital that was out-of-network.1 The in-network/out-of-network challenge plagues thousands of Americans who seek care every year. It’s one way our healthcare… Read More →

How Do You Choose the Best Doctor?

Whether you’re an employer investigating physicians in a new health network, or an employee looking for the right network doctor, you might turn to Healthgrades, Vitals, or Yelp like many consumers. In fact, 69 percent of consumers select or avoid doctors based on online reviews.1 But should we? What happens when consumers control our healthcare decisions? We rely on the opinions of consumers like us to help us make choices every day—from the kind of… Read More →

Why is Healthcare Quality Important?

Medical mistakes in hospitals are the third leading cause of death in the United States.1 In fact, an American College of Surgeons study found that 8.9 percent of surgeons said they’d made a medical error in the last three months, and 1.5 percent said they believe that error led to a patient’s death.2 Although the cause for error was attributed to burnout in this study, other factors exist that can contribute to care complications and… Read More →

An Aging Workforce Can Mean Higher Surgery Costs

As people live and stay active longer, you can expect more older people than ever in the workplace over the next four decades, and this can equate to an exponential rise in healthcare costs for plan sponsors. As AARP CEO Jo Ann Jenkins pointed out, when Ethel Percy Andrus first founded the institution in 1958, “there weren’t all that many older people around.”1 But that reality has completely changed. Consider these facts: Less than two… Read More →

Value-Based Surgery Benefits Enable Employers to Help Cash-Strapped Workers Get Needed Surgeries

Here are the troubling facts: 60 percent of bankruptcies are due to medical bills. Despite having year-round insurance coverage, 10 million Americans ages 19-64 face medical bills they cannot pay.1 About 15 percent of people say that at least once in the past two years, they couldn’t get the healthcare they needed; 58 percent of those said it was because they couldn’t afford it. And 19 percent of poll respondents report that they didn’t fill… Read More →

Provider Quality Counts in Choosing a Surgery Benefits Program

By Mark Stadler, President & CEO With the high cost of healthcare to businesses and workers, employers must rein in runaway spending. But it’s just as critical to provide workers with the very best care money can buy. This is what value-based healthcare is all about: quality care for less. Unfortunately, unwarranted variations in care are rampant, and provider quality is uneven in government and employer-sponsored health plans. Overuse and unnecessary care account for anywhere from… Read More →

Value-Based Surgery Benefits Advance Consumerism and Employee Engagement

By Shane Stone, Senior VP of Sales According to a recent survey of chief human resource officers and senior benefit managers, employees are suboptimal health consumers and do little shopping for the best cost and quality of care delivery.1 HR execs largely agree on the pressing need to move toward more consumerism.2  To enable greater consumerism, workers must be better educated on how to seek transparency and quality data when making specific healthcare decisions. But… Read More →

Huzzah for HHS Nominee Azar!

We applaud HHS secretary nominee Alex Azar for certain comments earlier this month. In testimony before the Senate Finance Committee, Azar supported mandatory bundled payment models in Medicare. We wholeheartedly agree. Mandatory bundled payment models are the logical next step by CMS based on findings of its Center for Medicare & Medicaid Innovation. Released in November 2017, an evaluation of Medicare’s Bundled Payments for Care Improvement initiative found that for the highest volume clinical episodes,… Read More →

Employers Armed With Innovative Weaponry Take Aim at High-Cost, Low-Quality Healthcare

By Jesse Gomez, Executive VP of Sales & Marketing Last year we witnessed the Trump administration, Congress and the American people engage in a fractious debate about healthcare reform. In a national discussion marked more by heat than by light, some called for an end to employer-sponsored insurance (ESI), but ESI shows no signs of going away and continues to meet the healthcare needs of a multitude.  The majority of Americans receive coverage from employers… Read More →