Transparent Cost and Quality Information Saves Average of $550 per Case
FRANKLIN, Tenn.--(BUSINESS WIRE)-- MedSolutions (http://www.medsolutions.com/) today announced SmartChoice, an innovative program that proactively provides health plan members with transparent cost and quality information about diagnostic imaging and other services. It is designed to help consumers take responsibility for their own physical and financial health.
In the initial rollout phase of the program, MedSolutions found that SmartChoice saved an average of $550 per case, representing significant value for health plans and their members. Overall, 96 percent of participants reported that the information provided was helpful to their decision-making.
“What separates this program from others that attempt price transparency is that SmartChoice brings information directly to patients – they don’t have to go out looking for it,” said Curt Thorne, president and chief executive officer for MedSolutions. “SmartChoice finally puts consumers in the driver’s seat, giving them the opportunity to make choices that will save money while maintaining the highest quality care. In a tough economy, this can have a huge impact on consumers and health plans alike.”
Typically, patients approved to receive services like diagnostic imaging or sleep studies are referred to a specific facility without being provided cost or quality information or alternative locations. SmartChoice works in partnership with health plans to share that information directly with members, empowering them to make the best decisions for their pocketbooks, health and convenience. Here’s how the program works:
- After a patient has been approved for a service such as an imaging scan, a SmartChoice representative proactively reaches out to him or her over the phone.
- The SmartChoice representative provides clear pricing information for nearby facilities. Those facilities meet specific quality standards and are within the member’s insurance network.
- For added convenience, the SmartChoice representative can narrow the facility locations to those that are close to the patient’s home, office or doctor based on his or her preference.
- The patient has the option to have the appointment scheduled directly by the SmartChoice representative.
“This program is a natural next step for our company,” said Thorne. “For over a decade, we have been helping health plans ensure that patients get the most appropriate tests to meet their needs, and now, we are equipping those patients with transparent cost and quality information to help them make the best decisions about where to have those tests performed.”
Medical imaging is one of the major economic drivers in our healthcare system, costing over $100 billion annually. An article in the March 2011 New England Journal of Medicine highlighted the vast variations in healthcare pricing that patients need help navigating, as well as the significant savings that could be gleaned from increased transparency.1 For example, in Massachusetts in 2006 and 2007, the cost of an MRI for the lumbar spine, performed without contrast, ranged from $450 to $1,675 – a difference of over $1,200 depending on the facility used. The article went on to state:
“Since consumers are generally ignorant of such price differences, publishing price information could both narrow the range and lower the level of prices, in part by permitting consumers to engage in more cost-conscious shopping and select lower-cost providers and in part by stimulating price competition on the supply side, forcing high-priced providers to lower their prices (or accept smaller annual increases) in order to remain competitive.”
MedSolutions is witnessing just such an effect. Many of the imaging facilities charging the most competitive rates have reported an uptick in the scheduling of imaging studies. Conversely, some imaging facilities that charge higher prices have requested to renegotiate their rates to remain competitive.
In addition to the cost and quality transparency that SmartChoice provides, the program is harnessing technology to reach even more healthcare consumers. MedSolutions is currently piloting a program that will send SmartChoice reminders to patients via text message. Eventually, the full SmartChoice program will be available through patients’ mobile devices. With mobile internet users predicted to surpass desktop users as early as 2013, this is a critical step in reaching patients with information in a convenient way.
MedSolutions has long been recognized as a leader in helping commercial and government health plans manage their medical costs. SmartChoice represents the first time the company is reaching out directly to consumers.
MedSolutions is a medical cost management company, saving money for health plans and people by improving patient care. We achieve this through management programs for advanced imaging, cardiac imaging, radiation therapy, ultrasound, sleep management, oncology, spine surgery and implantable cardioverter defibrillators (ICDs), as well as our groundbreaking Premerus® program, which ensures that patients receive expert diagnoses. We approach everything we do like a treating physician. We base our guidelines on patient symptoms. Our doctors and nurses review patient cases within their specialties. We reward physicians who consistently provide the best care. MedSolutions aligns the best interests of health plans, physicians and, most importantly, patients. We are proud to help 27 million Americans receive higher quality, lower cost healthcare. MedSolutions has been recognized for outstanding customer service and effective call center management by the International Customer Management Institute and for four consecutive years by the prestigious J.D. Power and Associates Award. Visit www.medsolutions.com.
1 Sinaiko, Anna D. and Rosenthal, Meredith B., “Increased Price Transparency in Health Care — Challenges and Potential Effects,” New England Journal of Medicine, March 10, 2011. http://www.nejm.org/doi/full/10.1056/NEJMp1100041
Katie Lilley, 703-889-8504 x2
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