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Keeping cost in check

The price of health care in Washington state is all over the map. In fact, some health care providers charge as much as twice (or more) than what other providers charge for the same procedure, such as joint replacement or the birth of a child, even though the patients they see aren’t any sicker.

Even if the doctor or hospital you’re seeing is “in network,” you could end up paying more than you would for the same procedure someplace else.

Higher cost ≠ higher quality

Paying more for care doesn’t necessarily mean the care you receive (and ultimately your health) will be better. So what can you do to make sure your costs stay reasonable?

Do your research

Use your health plan’s cost estimator.

Login to your health plan’s website or call the customer service line to access tools that will help you estimate the cost of a procedure or office visit. That way you don’t have to wait until the bill arrives to find out how much you owe.

Avoid the emergency room

Different care settings deliver different types of care.

If you’re in need of immediate, emergency health services, the emergency room is there for you. But if it’s not an emergency, and you go anyway, the costs can really add up. Instead, turn to your neighborhood urgent care facility. Urgent care is a good resource if you have something that can’t wait, but isn’t a true emergency.

You should also call your primary care provider and see how soon you can get in. You may be able to get an appointment sooner than you think.

In short, to avoid spending money needlessly, you should choose your primary care provider or urgent care whenever possible and leave the emergency room for true emergencies.

Learn more about when to use the emergency room and when you shouldn’t from the Washington State Medical Association’s ER is for Emergencies campaign.

Ask these five questions

If your doctor suggests a treatment, find out more. Determine if it’s necessary before you act. Your doctor should consider your values and help you reach a decision.

  1. Do I really need this test or procedure?
  2. What are the downsides?
  3. Are there simpler, safer options?
  4. What happens if I do nothing?
  5. What will it cost?

When it comes to your health, cost shouldn’t be the only factor. Quality and patient experience are very important, too. But you shouldn’t pay a premium on care that doesn’t give you a good result. Understanding what a procedure or treatment will cost beforehand will help you plan for its impact on your physical and financial well-being.

Remember:

  • There is no correlation between the cost and quality of care – You cannot determine the quality of the care you will receive based on the cost of that care. In some cases, more expensive care is the best care. But in some cases, it is not.
  • Less expensive treatments are sometimes a better choice than more expensive treatments – For example, for a back injury, physical therapy may be more effective and less expensive than surgery.
  • Some settings of care are more expensive than others – A visit to the ER can cost about 10 times what it costs to visit a primary care doctor, so be sure to consider cost when you’re deciding where to go for care.

Cost should be part of the equation for good, high-value health care, as much as patient experience and quality. Learn more about how to find high-value health care and how be a savvy health care shopper.

savvy_shopper_cost_infographic

Infographic: Washington Health Alliance.

This post is fourth in a series called The Savvy Health Care Shopper. The Washington Health Alliance is partnering with the Washington State Health Care Authority’s Healthier Washington initiative to educate consumers on finding value in health care.

 

Published: December 1, 2015

About Washington Health Alliance

The Washington Health Alliance is a place where stakeholders work collaboratively to transform Washington state’s health care system for the better. The Alliance brings together organizations that share a commitment to drive change in our health care system by offering a forum for critical conversation and aligned efforts by stakeholders: purchasers, providers, health plans, consumers and other health care partners. The Alliance believes strongly in transparency and offers trusted and credible reporting of progress on measures of health care quality and value. The Alliance is a nonpartisan 501(c)(3) nonprofit with more than 185 member organizations. A cornerstone of the Alliance's work is the Community Checkup, a report to the public comparing the performance of medical groups, hospitals and health plans and offering a community-level view on important measures of health care quality (www.wacommunitycheckup.org).

2 Responses to “Keeping cost in check”

  1. Tara Jones

    Thanks for these tips, especially the reminder to use the emergency room for actual emergencies! (I’m sure that if everyone did that, there would be much less time spent waiting to see a doctor.) I have small kids, and so every little thing seems like it has the potential to be an emergency. In what kind of situations would you recommend taking kids to the ER? I should probably have a list somewhere so I can know that I’m always making the right decision. http://www.tricitymedical.net

    Reply
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