Usually that’s what we think. If it costs more, it’s got to be better, right? A more expensive car or truck has to be better than a standard one. Sometimes it’s the features that we choose that drive up the price, but does it perform better?
When was the last time you bought an expensive pair of shoes, only to complain that your feet hurt? Food can sometimes be the exception but when it’s the same burger, is two or three times the expense worth it?
That’s how we buy healthcare – if this place or this provider charges more, than it’s got to be better. Most times we don’t know the price in advance, and we never know what the quality is. Price means nothing without quality.
In healthcare, quality outcomes are THE MOST IMPORTANT thing. Lower costs will follow because quality gives you:
- Lower Readmission Rates
- Reduction in Patient Harm
- Fewer Misdiagnoses
- Fewer Complications
- Lower Infection Rates
- Appropriateness of Care
This translates to lower costs. So how do you measure quality?
There are several organizations including Quantros, Leapfrog, and the Centers For Medicare and Medicaid Services that publish outcomes for physicians and facilities. Take a look at these 2 different Major Orthopedic Facilities and Quality vs. Cost:
Facility #1
Facility #2
Which Facility would you want to go to?
What we need as consumers is assistance to access this type of information because it’s not readily available and/or very difficult to find. Usually we go to facilities based upon where our specialist tells us to go (actually where they have admitting privileges) or word of mouth from friends or family based up their experiences or what they’ve heard. Strange way to go about finding quality, right?
There’s now a National program that can help employees and family members access quality care information as well as negotiated rates. Think of this as a ‘bolt on’ program to your existing PPO. Members can continue to use the PPO and pay deductibles, out-of-pocket expenses as they normally would, or they can use the Navigation service and have all out-of-pocket expenses waived. When members have higher quality with better outcomes, satisfaction is higher and costs are lower – hence waiving all member expense.
This is something every employer should look into. Mind you, not all navigation services are alike but if you’d like to learn about the one I’m recommending, please reach out and we can chat.
