NPR wonders why we would shop for a couch but are willing to pay an outrageous price for a medical service.
Why is it we are willing to visit a few stores to get the best deal on a television or a couch, but when you want to purchase a health care service such as a blood test, or an MRI, most of us just go, and then wait to find out how much it would cost us when we got our insurance bill. Of course, some healthcare services such as rehab, your local therapist, or your chiropractor are not alike however, many tests do not differ from hospital to clinic to facility, and are basically interchangeable, so why pay more?
NPR investigates this phenomenon which seems to only exist in the world of healthcare, and has allowed the price of many healthcare services to vary greatly in the same area. In my own experience, the price of an MRI can vary greatly from one facility to another, and if you have insurance with a high deductible, as I did, the cash price may be under $500 but just because the insurer negotiated a price of about $800 for the test, that is what I paid. So much for trusting insurers to negotiate for us.
Recently, Horizon has created a new tiered network called Omnia which is supposed to give us a savings of 15 percent while pushing many of the larger hospital networks to give them better rates in exchange for more patients. This model used to be called a PPO except they excluded a number of hospitals and did not even give them an opportunity to look at what they offered. Also, a number of hospitals have merged creating monopolies which made negotiation more difficult, since they were able to now dictate fees for their services and the practices they purchased. You can read more about the concerns this creates here.
A new company has developed a model that saves insurers money when you have a service performed and pays you cash for using those facilities says NPR. Basically, if you use the less expensive lab or MRI (services that do not vary like rehab can for instance), if you use the less expensive facility, they save money and you get a check. For some services, the savings can be substantial and if you require high cost services, so can your earnings.
I am not sure if this service will come to NJ, but it sounds like it may. Check it out here