Quit Wasting My Healthcare

Patient Decision Making

August 4, 2009 – 7:38 am by ScottSchoenvogel

Here is a good article from the WSJ on the power of patient decision making and illustrates the fact that there is no one right answer when it comes to health - each patient / consumer is unique http://online.wsj.com/article/SB10001424052970203674704574328570637446770.html Compass can help patients understand their options and can point them in directions where they can get more information so they can be both an informed patient and consumer.

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Oz of Prevention = Pound of Cure?…Maybe Not When It Comes to Cost

August 4, 2009 – 7:19 am by ScottSchoenvogel

Take a look at this article from MSNBC http://www.msnbc.msn.com/id/32275652/ns/health-health_care/ In this article, the National Institute of Health recognizes that certain activities such as preventive testing do not necessarily save money. The takeaway for the consumer has to be that preventive testing is not necessarily the answer for health care cost containment. That being said, the article participants still find preventive tests extremely valuable in terms of their ability to save lives.

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Physician & Hospital Accountability

August 1, 2009 – 4:04 pm by ScottSchoenvogel

There is a reason why healthcare consumerism has the potential to be such a powerful force for change: an empowered patient is the only person to whom a physician or hospital executive feels any accountability. The primary purpose of both physicians and hospitals is to serve and heal patients, often in a time of individual pain or crisis. The patient, usually at their weakest point, has to place an extraordinary level of trust in their care provider to treat them both fairly, kindly and efficiently according to his or her individual value system. While there are many forces pushing healthcare providers, violation of a patient's trust shakes them to the very core. It is easy for a healthcare provider to turn the other way when patients are not educated consumers. Unfortunately, many providers use this lack of understanding or transparency to take advantage of the inefficiency inherent in the healthcare system today. By educating yourself and communicating your personal quality ...

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Accessing $4 Prescriptions

August 1, 2009 – 3:39 pm by ScottSchoenvogel

$4 prescriptions exist for more and more medications. The problem is that most participating pharmacies choose to only offer $4 prescriptions in specific amounts and dosages. That means that you may not get the $4 price if your doctor prescribes you a dosage or an amount that does not meet the pharmacy specifications. There are two ways to address this situation: 1. Take the $4 list from your pharmacy to your physician and ask if you can address your prescription needs with the specific prescriptions on the list 2. Use Compass to coordinate that conversation with your doctor on your behalf Either way, be a savvy consumer and don't let a few pharmacy tricks keep you from paying the true cost of care.

Posted in Costs of Care | No Comments »

Healthcare Reform & Consumerism

August 1, 2009 – 3:19 pm by ScottSchoenvogel

I continue to read countless articles about the various healthcare reform bills that really do not have much to say other than everyone disagrees on how to move forward and whatever happens should cost more than financial bailout. Well, I guess there are tidbits about a public insurance option, increased taxes for the wealthy, and some protection for those with pre-existing conditions. Does all of this healthcare reform talk have any implications for consumers? The answer is not yet but it might over the long run. For the interim, I suspect it will be business as usual because of the huge financial forces keeping the current system in place - the great "hidden" private insurance tax subsidizing the true cost of government programs. Medicare and Medicaid pay 25% less than the cost of care and private insurance pays 27% more than the cost of care. The net 2% is profit for large healthcare system providers which ...

Posted in Costs of Care, Health Insurance Premiums, Universal Healthcare | No Comments »

Beware of In-Network Doctors with Out-of-Network Facilities

July 31, 2009 – 1:52 pm by DrEric

As a patient and healthcare consumer, you can get caught in a trap that can cost you a lot of money. First as background, many medical services have two bills--the doctor bill and the facility (i.e. hospital or surgery center) bill. Some doctors who perform procedures--such as gastroenterologists that perform colonoscopies and surgeons that perform operations--do so at facilities that are Out-of-Network. So here is the trap... The doctor themselves may be In-Network so that when you see them in the office before the procedure it may be a low copay or low out-of-pocket cost, but when you actually have the procedure done, the facility bill will be VERY large and you will be responsible for MORE of the bill. For example: In-Network colonoscopy facility fee: $800 You may be responsible for 10% coinsurance, so you pay $80. Out-of-Network colonoscopy facility fee: $3,000 You may be responsible for 30% ...

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Infusion Drugs–Get the Medication You Need at the Best Price

July 23, 2009 – 9:01 am by DrEric

There is a large difference in the price of medications that are infused at a doctor's office depending on what doctor you see or where you have the infusion performed. Medications such as Remicade used to treat intestinal illnesses like Crohn's Disease and joint diseases like Rheumatoid Arthritis can cost $4,000 at one doctor's office and $2,000 at another. Why is there a price difference? Different doctors have contracted with insurance companies for different prices for the same medication. If you are looking for a new doctor and you think you may have one of these illnesses and require an infusion medication, ask the doctor's office staff what the "contracted price" for the medication is. If you only have a $20 copay then the price difference may not matter to you. However, a lot of people must pay their deductible and co-insurance on infusion medications. That $2,000 ...

Posted in Behavior Change, Costs of Care | No Comments »

Framework for Thinking about Healthcare: Access, Quality, Cost

July 16, 2009 – 6:40 am by DrEric

Anytime you read an article about healthcare or hear a news story about healthcare, think about it in terms of how it will affect (1) Access, (2) Quality and (3) Cost. Healthcare is a 3-legged stool and these are the legs. When you are deciding for yourself if a change to healthcare is for the better or worse, think about how it will affect Access, Quality and Cost. Do the changes proposed by Washington increase Access to care for everyone? Do they may make Access more limited for certain groups or locations? Do the changes improve Quality? In what ways do they make Quality worse? Do the changes lower the Cost of healthcare? Do they lower the Cost for some while raising the Cost for others? Do they lower the overall Cost for everyone? I will leave it up to you to answer these questions for yourself, but thinking about ...

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Consumers as ‘Stewards’ to Address 4 Issues that Stymie Health Reform

June 30, 2009 – 3:18 pm by DrEric

The Associated Press reported today that there are 4 issues that "could dash President Barack Obama's hopes for overhauling healthcare." (http://www.boston.com/news/nation/washington/articles/2009/06/30/hard_choices_on_4_big_issues_stymie_health_push/?rss_id=Boston.com+--+Latest+news) Issue #1 - Cost - $1 - $2 Trillion over the next 10 years Consumers as 'Stewards' can lower cost by including cost in the healthcare decision making process. The doctor in the exam room and their patient must talk about cost. If a doctor and patient view healthcare as spending someone else's money, costs will never be controlled. Incentives must be aligned so that as good stewards of health and healthcare resources, physicians can offer and consumers can receive equal--and often better--care at a lower cost. Issue #2 - Employer Mandate Consumers as 'Stewards' can reduce the need for an employer mandate by purchasing insurance on the open market. For employees who currently work for companies that do not offer health insurance, there is an option to purchase ...

Posted in Behavior Change, Costs of Care | No Comments »

Overutilization Again Identified as Cause of High Healthcare Costs

June 5, 2009 – 3:07 pm by DrEric

The recent article in the New Yorker entitled "The Cost Conundrum--What a Texas town can teach us about health care" is very good: http://www.newyorker.com/reporting/2009/06/01/090601fa_fact_gawande?currentPage=1 Atul Gawande has laid out the underlying cause of high healthcare costs: Overutilization. In my opinion, he has hit the nail on the head. I want to make as few comments as possible so that the article can stand on its own, but I can say that addressing overutilization at the patient-physician relationship level is the best way to improve quality and decrease cost at the same time. Physicians respond best to their patients. Having the government, insurance companies or large employers dictate practice patterns and treatment recommendations will generate tremendous push-back from physicians. No matter how well "proven" or well intentioned those recommendations, the shear fact of who they are coming from will discredit them by physicians. One can say that is not right, ...

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Quit Wasting My Healthcare

Patient Decision Making

Oz of Prevention = Pound of Cure?…Maybe Not When It Comes to Cost

Physician & Hospital Accountability

Accessing $4 Prescriptions

Healthcare Reform & Consumerism

Beware of In-Network Doctors with Out-of-Network Facilities

Infusion Drugs–Get the Medication You Need at the Best Price

Framework for Thinking about Healthcare: Access, Quality, Cost

Consumers as ‘Stewards’ to Address 4 Issues that Stymie Health Reform

Overutilization Again Identified as Cause of High Healthcare Costs

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