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Why your health premiums could jump higher in 2013

Christian Schappel
by Christian Schappel
April 18, 2012
2 minute read
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Here’s some info worth passing along to your employees that could help control rising health insurance premiums.
Your health plan could end up paying up to 755% more for the same service in the same area depending on which healthcare provider they go to. And the more your health plan pays, the more insurance premiums will increase next year — for both you and them.
So it’s imperative employees shop around, particularly when it comes to preventive care — mammograms, Pap smears, colonoscopies, well-child visits, flu shots and other services designed to catch and prevent serious conditions.
These services are not “free,” although to employees it may seem that way since health plans are now required by the healthcare reform law to cover 100% of the cost of these medical services.
A recent study by Change Healthcare, which provides tools to help employers compare costs between healthcare providers, revealed many healthcare providers charge more — much more — than others for common procedures. And by steering employees toward lower cost, higher quality providers, health plans can save a lot of money long term.
The study is called the Healthcare Transparency Index. It was compiled using claims data from Change Healthcare clients over a 12-month period.
Highlights of the study:

  • The Index revealed a significant difference in costs for diabetes screenings with a low of $51 and high of $437, a 755% difference.
  • The cost for Pap smears ranged from $131 to $476 dollars in the same community, a difference of 264%.
  • The cost for a colonoscopy ranged from $786 to $1,819, a difference of 131%.
  • The price for a lipid panel test, the most common way to measure cholesterol, ranged from $117 to $374, a 219% difference.
  • The cost of a mammogram ranged from $169 to $403, a 138% difference.

Some of the most common reasons for the differences in price:

  • Whether the service is performed in a hospital, doctor’s office or ambulatory clinic
  • Whether a practice specializes in the procedure (which usual drives the price down), and
  • If the provider is in a rural or urban area.

Some steps to take to get employees to price shop and select lower cost providers:

  • Ask you health plan provider for price comparison info that can be distributed to employees, and
  • Only give employees a certain amount to spend on a procedure and tell them they are responsible for any overages. (Note: Consult your health plan provider to make sure the amount given is enough to cover the average cost of the procedure in your area.)

Info: To download the Health Transparency Index, click here.

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