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Innovation: Health care cost estimator
UnitedHealthcare has launched an online tool that gives consumers the ability to compare prices for more than 550 different inpatient medical services.
The service, myHealthCare Cost Estimator (myHCE), is free to employers and plan participants at myuhc.com and through the Health4Me mobile app for iPhone and Android.
“It’s one of the first times that patients and consumers are going to be able to look at the real costs of procedures and be able to compare them,” said Dr. Bruce Weiss, senior medical director, UnitedHealthcare of Wisconsin. “This is really going to give (people) an opportunity to do comparisons of costs and look at them in detail for provider and facility.”
Weiss said this service brings “retail-like comparison shopping to health care,” combining “quality information on providers as well as actual cost.”
“This is somewhat groundbreaking in that we are sharing this level of detail,” Weiss said. “Hopefully, people will take advantage of it and ask questions about (the costs).”
Jon Sohn, chief financial officer at Wheaton Franciscan Healthcare, said myHCE is a “tool that attempts to communicate prices on the front end,” and said it is a “step in the right direction.”
MyHCE is tied directly into benefits, so patients can not only gain an understanding of a procedure’s cost, but also detailed information about how insurance benefits will figure into the end cost, how much the insurer has paid and what out-of-pocket expenses someone may incur, Weiss said.
“It really understands what you’ve paid toward deductible and co-insurance,” Sohn said. “This spells out for you what your ongoing responsibility will be.”
UnitedHealthcare has been rolling out aspects of myHCE over the past two years. Late last year, inpatient services were added, enabling consumers to comparison shop for procedures like knee replacement, spinal surgery and childbirth.
“Adding inpatient services enables myHealthcare Cost Estimator to provide consumers even more crucial information that is personalized, relevant and accurate,” said Yasmine Winkler, chief product, marketing and innovation officer at UnitedHealthcare. “MyHealthcare Cost Estimator enables people to make better care decisions by better understanding their treatment options, comparing services and anticipating future costs.”
According to an August report from the Agency for Healthcare Research and Quality, childbirth, back problems and hip fractures were among the most expensive treatments, combined amounting to more than $25 billion in 2011, UnitedHealthcare spokesman Kevin Shermach said.
In an analysis of back pain procedures completed at different health systems in southeastern Wisconsin, UnitedHealthcare found that the price of procedures can vary by tens of thousands of dollars based on where they are performed. For example, the average price for a “lumbar fusion” in the region is $58,536, but prices range from $53,520 on the low end to $97,565 on the high end.
In addition to providing information on an individual inpatient procedure, myHCE gives costs for “care paths,” which encompasses much more in terms of additional services that augment a procedure, giving a better picture of the “cost in total to get something done,” Weiss said.
“If a patient is concerned with the cost of health care, (Wheaton will) provide a similar process,” Sohn said. “The nice thing about myHCE is that (it) provides not just an episode, but provides an entire course of treatment.”
MyHCE provides pricing and quality information for more than 550 services across more than 220 “episodes of care,” not just isolated procedures.
Sohn said it’s a good tool to help patients recognize the bigger picture of care.
“More and more, patients have to take control of their health care,” he said. “We as a community have shifted to having patients make more (educated) decisions.”
Since myHCE’s initial 2012 launch “thousands of consumers have used the tool to compare the quality and cost of various treatments and services, generating more than $200 million in estimates,” according to UnitedHealthcare. Now, that number is expected to increase with the addition of inpatient services.
But the end objective, Weiss said, is transparency.
“The ultimate goal is to provide better transparency for consumers so they can make better choices. And with greater transparency, they will get more rational pricing,” he said.
Sohn said this goal also aligns with Wheaton’s push toward transparency in care.
“Our goal is to provide transparency toward care,” he said. “We want to make sure patients have these numbers and know what their responsibility is going to be.”
UnitedHealthcare is hoping this new level of transparency will be a catalyst toward better decision-making among its members.
“Hopefully, it will spark interest in our members to take greater ownership of their health care and really seek out some of this information so they can spend their health care dollars wisely,” Weiss said.