How My Healthcare Knowledge Helped My Family

I work for a company called Trig. Our goal is to increase benefits and healthcare literacy. It’s that simple. Fortunately, I am one of those people who seldom go to the doctor (knock on wood, throw salt over my shoulder, etc.). Therefore, this knowledge has personally, rarely been needed (thank goodness!), however, I can pass this information on to those I care about and our hope is that Trig users do the same.

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Saving Money Was Easy For This Family With The Flu.

I get it, asking you to change your routine for how you go to the doctor or get a prescription can be annoying. Whether you’re sick, not feeling well or the trip to the pharmacy is just one more errand on your growing to-do list, sometimes it can be worth the extra price just to keep doing things the same way you always have. My family usually gets our prescriptions from Costco or Wal-Mart because typically they are less expensive. There have been times though, that the convenience of the drive though at Walgreens or CVS has swayed us. When we are in a hurry and don’t want to lug kids in and out of the car, wait in line, etc., we may forgo the savings. For the most part however, we have been mindful of saving money when we could on our medications. Or so I thought.

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Aetna’s Faux Pas and the “Millennial” Response

Admittedly I’ve never been a C-level executive at an insurance provider, nor have I been employed as a claim adjuster for an insurance company. But it seems to me that even those of us who have never had to approve or deny health insurance claims know that someone charged with that great a task should be highly qualified. A recent CNN article sees insurance provider Aetna under intense scrutiny for admitting that their own medical directors don’t look at medical records when approving or denying a claim.

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Over-treatment – How much healthcare is wasted and what it’s costing YOU.

It’s safe to say that I use a regular amount of healthcare. I’ve never been dramatically ill, but have undergone a few minor surgeries here and there. Members of my family have had more major procedures, and may again in the future. As a common healthcare consumer, I definitely don’t feel like most articles or news stories are written with me or my family in mind. They are about as distant as a Dow Jones report, written for investors in suits, reading it from a far away office with lots of shiny glass.

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How education can beat the odds

As we often discuss in this article series, the notion of healthcare education and outreach is very important to us and to our clients. We firmly believe that it is key to making an impact in your claims cost, and in getting an overall positive experience out of your care. But can we really expect to see an impact? You can. By targeting individual programs that solve specific issues that a company may be facing, and promoting the heck out of it, you can seriously make an impact. You see, people traditionally haven’t been in the driver’s seat of the claim management role. Until now. You can teach people how to ask the right questions at the right time, educate them on the process and give them your most effective tools and solutions.

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The cost of a medical misdiagnosis

It’s no secret that misdiagnosis in the medical industry is extremely common. So common, in fact, that if you’re a member of a group health plan, someone on your plan has probably recently been wrongly diagnosed. About 12 million people are misdiagnosed each year. And this makes life much more expensive. Think about it – if you’ve gotten care for the wrong illness, your initial ailment would have gotten worse during that time, because it’s gone untreated.

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Why High Deductible Health Plans Don’t Work

High deductible health plans are insurance coverage where your deductible (amount that you have to pay before insurance kicks in) is over $1,300 per year for a single person or $2,600 for a family. We’ve written a lot about this kind of insurance coverage for 2 reasons.

1. Because a lot of people have it. About 40% of insured people are now on a “high deductible” plan.

2. The plans are supposed to improve the quality of care and reduce costs.

The plan is aimed at saving money in the long run. The idea being that you can keep the extra cash in your pocket now and be incentivized to shop around and be a good “consumer” when it comes time to spend your money.

But this theory doesn’t always work. A lot of people don’t like, want or know how to use their high deductible plan. A lot of people want a plan that affords them the flexibility of being able to go where they want when they want. And they don’t want to think about money when it’s time to see the doctor. While we’re all for taking an active role in your healthcare, the idea of that your high deductible plan will be enough encouragement is not always true.

We improve health literacy

Let’s look at why high deductible plans don’t work

  • People don’t know how to be consumers – Nobody teaches you how you’re supposed to go to the doctor. There are no college courses on being a good “healthcare consumer” or on how to pay your medical bills (seriously, it’s a lot more complicated than you think).
  • People don’t know why they should care – most of us are brought up with the mentality that “the doctor is always right“. It’s fine to rely on the doctor’s expertise, but the patient does play an important role. And as a patient, you can’t be entirely passive.

What does all of this mean? It means that people generally do not shop around, price compare or think about the quality of care that they’re getting. People have been conditioned to ride the conveyor belt of healthcare, and take what comes to them.

How can we make a high deductible health plan work?

Not all high deductible plans are unsuccessful. Far from it.

If a company introduces a high deductible plan with sufficient support in place, costs can be reduced. Employees will also receive better and more comprehensive care. How exactly can you achieve this?

  • Educate your employees on the “levels of care” – It’s important to know where to get care when you need it. Don’t go to the emergency room for a cold.
  • Get a telemedicine company – You can save serious money and have an extremely convenient doctors appointment. Telemedicine is so underutilized, its one of the first things that I always recommend.
  • Talk about 2nd opinions – People need to know that they should get a second opinion, especially if they’re getting treated for something serious. Before getting extensive care it pays to get a third party to verify the condition. There are ample resources out there for getting a cost effective second look.
  • Price compare for prescriptions – This is a very easy one. Most people just get their medications filled at their regular pharmacy. This is a seriously lost opportunity to save some cash. You could be paying many times more than you should be.

What is Healthcare Consumerism?

The term “healthcare consumerism” is still relatively new, because its a relatively new idea. For years and years we’ve viewed healthcare as being out of our control and only getting worse. We were partially right – it is getting worse. That’s why most people have turned to “high deductible” plans (more on that here). Whether its through your employer’s plan, something you’ve purchased independently or even a plan that you’ve gotten through Obamacare, chances are, it’s deemed as “high deductible”. The idea is that we’re going to increase your financial risk (might have to hit that high payout [deductible] or you may not), but you’re going to be able to keep more money in your pocket now, and have to decide how you’re goin to spend it.

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Healthcare Cost Comparison Can Save You

I was checking out this article in Vox Magazine, its about a family who was charged $25,000 for an MRI from her local hospital in California, where comparable procedures cost just over a thousand dollars. The article goes on to address the cost for the same procedure in other countries where patients would pay about 75% less. It should be immediately obvious how important healthcare cost comparison is.

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