Compass has been providing a healthcare price-transparency solution to employers for three years and Castlight Health raised $80 million to try to do what Compass is doing.  Prominent venture capitalists and the Cleveland Clinic gave Castlight Health $80 million for a similar value proposition to Compass.  Castlight’s fundraising further supports the Compass value proposition.  If we were the only people to think of this, then it probably isn’t a good idea.

Compass’ 120+ employer clients in 46 states are actively using Compass to shop for lower cost healthcare services.  Not only are Compass customers saving money, but they also have higher levels of benefit satisfaction and feel very supported during the paradigm shift to a consumer directed health plan.

Consumerism will continue to address these trends in a positive fashion for employers and their employees. There are many examples of this positive effect of consumerism. The Land O’Lakes, Inc experience is just one of them: http://newsroom.cigna.com/article_display.cfm?article_id=1144

Now that the legislation has passed, Consumerism will still bring Lower Cost, Improved Quality, Better Access.

While no-one wants to see healthcare costs continuing to increase, you can prepare and protect yourself against these changes when you use Compass as your guide. We are only the only service with the market intelligence and consumer savvy to help you get ahead of your healthcare decision making. Compass gives you the tools to know how to spend your money wisely while accessing the quality care you need.

Here is his last paragraph:

“Before we further remove ourselves as direct consumers of healthcare -with all of our beneficial influence on quality, service, and price – let me ask you to consider one more question. Imagine my father’s hospital had to submit the bill for his “care” not to a government bureaucracy but to my grieving mother. Do you really believe the hospital – forced to face the victim of its poor quality service, forced to collect the bill from the real customer – wouldn’t have figured out how to make its doctors wash their hands?”

http://www.cnn.com/2009/HEALTH/09/16/health.medical.bills/index.html

The problem is that the entire article missed the one crucial step that is important before going for any type of healthcare service: be an educated consumer. If you know how much the procedure will cost, where to get it for less, and what types of add-on drive additional cost, you will be prepared to manage your healthcare bill before it ever arrives and protect yourself from potentially devastating costs.

Unfortunately, this article is a regression to the type of article written 3-5 years ago. The field of advocacy is changing dramatically from the “find a doctor” / “fight a bill” to a comprehensive professional service that helps people not only navigate the health system and deal with problems but sophisticated pricing and quality data as well that allows you to become an empowered consumer. While the old world of patient advocacy will continue to exist, I would encourage patients and consumers to seek out this new level of professional experience to take control of their health care.

This is just one article in a larger number of writings recently that have started to focus on how to accurately calculate / negotiate the true cost of care (thus saving money by comparison shopping and becoming effective healthcare consumers).    Compass is thrilled by the focus on what it believes is the key to controlling healthcare costs.  Unfortunately, some of the messages in these articles are misleading.

The true cost of care is what your insurance has contracted to pay your doctor or hospital.  The hospital pricing tools sponsored by hospitals typically reflect only the charge.  The charge is generally unrelated to the true cost of care which is set by a contract with your insurance company.  Likewise, services such as New Choice Health simply use Medicare cost data and multiply it by some factor to “estimate” what insurance pays.  Insurance contracts (and thus true cost) generally have no relationship to Medicare cost information which makes these estimates very inaccurate.  To accurately anticipate your cost and evaluate healthcare service providers you must have the agreed to price from the insurance contract or fee schedule.

It is this level of market knowledge that Compass brings to the table.  We help our customers get beyond rough cost estimates and use actual fee schedule / contract data to make provider choice decisions.  When you have the Compass level of support and knowledge, you can truly be confident of your ability to assess your market options as a healthcare consumer.

There have been some interesting articles on how vaccination costs have risen to the point where group health insurance compensation is insufficient to support physician administration of vaccinations. In the individual insurance market there are even more complications – most benefit plans limit vaccination and preventive care coverage to $300 per year. This is just one more area where you will need the right expertise to make sure your physician provides critical services and if not, where can you get the best value for your money.

1. Heart Catheterization

2. Labor / Delivery

3. Outpatient Gastro-Intestinal Procedures (Colonoscopies / Endoscopies)

4. Advanced Imaging (MRI / CT Scan)

5. Back Surgeries