Latest Healthcare Transparency Index Reveals Key Drivers of Cost Variance for Routine Medical Services

Age, Location, Specialty and Retail Clinics Impact Cost of Office Visits

BRENTWOOD, Tenn.--(BUSINESS WIRE)-- The rising need for healthcare cost transparency remains a key focus for consumers, associations and government officials as the industry begins its shift to the accountable care organizations (ACO) model, hospitals continue to purchase private practices and the presence of “retail clinics” continues to expand. As a result, this quarter’s Healthcare Transparency Index from change:healthcare examines the factors creating cost variances for routine medical care.

As noted in a recent article from The New England Journal of Medicine, “the wide variation in medical prices within the U.S. creates an opportunity for transparency to reduce spending.” Backed by data from its Cost Transparency Solution, currently in use by more than 109,000 patients across 50 states, change:healthcare looked to reveal the source of these differences in cost and uncover how they impact spending for the majority of Americans currently responsible a greater amount of their own healthcare expenses due to higher deductibles and consumer driven health plans.

“Several studies have documented cost differences among major, big-ticket medical procedures and surgeries. But we still lack basic information about variability in everyday, routine medical visits that add up over time – not only for patients, but for the nation,” said Wendy Lynch, Ph.D., industry researcher and author of “Who Survives? How Healthcare Costs are Killing Your Company.” “As more and more consumers pay directly for their own healthcare, the need for this kind of healthcare cost transparency becomes even more essential.”

This quarter’s Healthcare Transparency Index reveals key drivers of cost variances for routine medical services:

  • Age – For check-ups and well visits, patients age 40 to 64 will pay up to 26 percent more per visit than 18 to 39-year-old patients. Of the 40 to 64-year-old group, internal medicine visits represented the greatest cost variance, with a low of $100 and a high of $225 per visit.
  • “Retail” or “kiosk” clinic vs. traditional office visit – Routine children’s physicals for camp, school and sports represented the biggest opportunity for savings, with a high of $160 at a primary care physician’s office versus $29 at retail clinic. As many clinics publish prices on web sites, the cost transparency and after-hour or weekend availability also make it an appealing option for minor cases where the patient has a general idea of his or her diagnosis.
  • Location – For the purposes of this report, change:healthcare compared costs in three mid-sized cities: Burlington, Vt., Oklahoma City, Okla., and Memphis, Tenn. Of the three areas, patients in Vermont were paying the most for office visits and lab tests – for example, up to $40 for a strep test, as compared to $12 in other areas.
  • Specialty office appointments – Psychotherapy as a speciality has the greatest variance by market amongst speciality medical care. Podiatry has the least variance.

“Cost transparency is going to be a critical piece of the puzzle as we move toward an ACO model, where all parties – from patients to hospitals to physicians to payors – are much more holistically involved in care,” said Christopher Parks, CEO of change:healthcare. “Since first launching the Healthcare Transparency Index last quarter, our company has had incredible traction in the marketplace, which proves how critical our pricing information is to the success of self-insured employers who traditionally had no way to empower employees to make informed decisions about their healthcare.”

Additional Resources

About the Healthcare Transparency Index

More than 60 percent of self-insured employers in the U.S. are expected to offer a consumer driven healthcare plan in 2011 as a way to curb healthcare costs. Employees and their families will be increasingly accountable for “shopping” and paying for their healthcare, making it more critical than ever to understand the costs involved. Currently, consumers of healthcare have no information and no tool to help them make decisions. The Healthcare Transparency Index (HCTI) is the first to provide healthcare consumers with ongoing trends data about actual healthcare costs, offering insight into critical opportunities for savings. The data is sourced from change:healthcare’s proprietary, HIPAA-compliant database generated from client activity. This quarter’s Healthcare Transparency Index includes data derived from more than two million medical claims, totaling $340 million and representing more than 109,000 lives across all 50 states over a 12-month period. The report’s pricing and behavioral content is derived from the change:healthcare Cost Transparency Solution. For more information, please call 800-655-0732.

About change:healthcare

change:healthcare (www.changehealthcare.com) has set the industry standard for true healthcare cost transparency – a critical component to the success of consumer-directed health plans (CDHPs) and to controlling the burden of rising healthcare costs. Built on more than three years of medical claims data, the company’s web-based Cost Transparency Solution provides employees with personalized views of pricing information and proactive alerts that highlight opportunities to save money on routine care and prescriptions in their local area. By enabling informed decision-making prior to selecting and receiving care, change:healthcare delivers substantial cost savings to both employers and employees. change:healthcare works with more than 100 self-insured businesses across the U.S., representing more than 100,000 lives.



CONTACT:

Lois Paul & Partners
Susan McCarron, 781-782-5767
[email protected]

KEYWORDS:   United States  North America  Tennessee

INDUSTRY KEYWORDS:   Practice Management  Health  Hospitals  General Health  Managed Care

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