One might think that health insurers aim to procure the most favorable rates for their customers. However, data collected due to the recent federal order requiring hospitals to disclose a complete list of prices they negotiate with private insurers has found that this, too often, is not the case.
The numbers are talking. And they certainly have a lot to say.
At the University of Mississippi Medical Center, a colonoscopy costs:
$1,463 with a Cigna plan
$2,144 with an Aetna plan
$782 with no insurance at all
At the Hospital of the University of Pennsylvania, a pregnancy test costs:
$18 for Blue Cross patients in Pennsylvania
$58 for Blue Cross HMO patients in New Jersey
$93 for Blue Cross PPO patients in New Jersey
$10 with no insurance at all
With numerous examples of cases like this where, according to the New York Times, “insured patients are getting prices that are higher than they would if they pretended to have no coverage at all,” it’s no surprise that hospitals were less than thrilled to disclose their lists. In fact, some have opted to ignore the requirement altogether.
Until now, this secrecy granted hospitals the ability to claim considerable ‘discounts’ when they could – and in some cases were – charging patients many times what public programs like Medicare were willing to pay.
Take Control of Your Costs
Simpara Founder and President Adam Berkowitz has and continues to be vocal about the topic of overpaying for health care. He’s shared data that shatters the myth of buying power yielding better pricing, shown how the Affordable Care Act has benefited Big Insurance, and of course, explained how Simpara helps employers get the best plans and prices.
Many employers know there’s a better way to manage the cost of health care spend and employee benefits but aren’t sure what the answer is.
Our answer? Self-funded health plans. And the results speak for themselves.
Seven months after making the switch to a self-funded health plan, one of our clients, Shine Solar, is paying $1,968 less per employee. And their employees are enjoying a $0 deductible.
How We Do It
We deal in direct contracting with local hospitals and care teams, aiming to create win-win scenarios for everyone involved, not just medical institutions. It’s our belief that you shouldn’t have to choose between high-quality care and an affordable price.
If you’d like to learn more about how we’re redefining how employers deliver world-class healthcare to their employees at a fraction of the cost, we’d love to get in touch.
Email us at info@simparaHR.com.
