A Blue Cross plan is giving self-insured employers and their employees a new web tool for finding the lowest cost healthcare provider and some financial incentive to use it.
Health Care Services Corp., a Blue Cross and Blue Shield licensed health insurer with 22 million plan members in Illinois, Montana, New Mexico, Oklahoma and Texas, is providing self-funded large employers with new web technology and services from health insurance comparison shopping portal developer Vitals.
The web tool is called Member Rewards and lets Health Care Services plan members compare costs and quality for numerous procedures, estimate out-of-pocket costs and consider treatment decisions with their primary doctors, the insurer says. The Member Rewards program will be hosted and managed by Vitals.
Vitals also will manage an incentive program that gives Health Care Services’ members a rebate on certain procedures that range from $75 to $300 when the members use a lower-cost option for a medical service or procedure, such as a magnetic resonance imaging (MRI) test, mammogram or hip replacement.
“Consumers may not be used to the idea of shopping for healthcare or be aware of the potential benefits of just a few minutes of research. But given the benefits and rewards consumers can achieve, we should move to a mentality where we shop for healthcare just like we do for other products,” says Health Care Services vice president, market solutions Tom Meier. “By pairing the right transparency tools to compare costs with a meaningful financial incentive for our members, we can empower them to be smart consumers of care and potentially help lower costs for themselves and their employers.”
The new program also will make use of Benefits Value Advisor, a Health Care Services program offered through its plans in Illinois, Texas, Oklahoma and New Mexico. The BVA program, available as an additional service to employers with 250 or more subscribers, is designed to show members their options for high-quality care at the best price.
Members who have a Benefits Value Advisor plan are encouraged and sometimes required to call an advisor to discuss provider options for receiving any of a pre-defined set of services. Using proprietary data, the Benefits Value Advisor database can tell the member how much the procedure costs and the quality ratings for nearby providers, then assist in scheduling and obtaining the necessary paperwork ahead of time.
More than 1,500 common medical procedures, such as CT scans, MRIs and endoscopy procedures, as well as spine, knee, shoulder and joint replacement surgeries, are incorporated into the database, Health Care Services says.
More than 190 employers are enrolled in the Benefits Value Advisor program and they have saved a total of $41 million since the program started in 2015, the plan says.
Date: December 19, 2016