You have probably heard or read reports about the importance of health care transparency. It wasn’t so long ago that you when went to see a doctor, or were admitted to the hospital, you simply assumed that you would receive high quality care. You didn’t worry too much about the cost even though you might have to pay some of the bill because the charges were reasonable and you could manage it if you had a job. With studies detailing the proliferation of medical errors and the explosion of health care costs, life has changed. Patients must be engaged in their own health care to get the best results at the best costs. This is where transparency comes in – giving you the information you need to do that.
GIC members have been the beneficiaries of health care transparency for a number of years:
- In 1999, the GIC was the first state organization to join the Leapfrog Group, a coalition of employers committed to reducing medical mistakes. Now you can find out how particular hospitals fare on patient safety simply by going to Leapfrog’s website.
- The GIC’s For Your Benefit newsletter includes articles such as this one to help members take charge of their own health care. Among the tools provided have been information about the Choosing Wisely® campaign (a list of tests and procedures that doctors themselves agree are overused) and questions you should ask before deciding to have a test or procedure. Consumer Reports is also promoting this effort. See the Choosing Wisely® site for additional details. Access For Your Benefit newsletter articles back to 1999 on our website:
- In its eighth year, the GIC’s Clinical Performance Improvement Initiative gives employees and non-Medicare retirees an incentive through lower copays to see specialists with higher quality and/or cost efficiency scores. Millions of physician claims are analyzed for differences in how doctors perform on nationally-recognized measures of quality and/or cost efficiency. You Select & Save, paying the lowest copay for the highest-performing physicians:
***Tier 1 (excellent)
**Tier 2 (good)
*Tier 3 (standard)
- Employees and non-Medicare retirees can save money every month on their premiums by joining one of the GIC’s Limited Network Plans. These plans have similar benefits, but on average cost 20% less than their wider network counterparts because they have a smaller network of providers (fewer doctors and hospitals).
- The GIC and our health plans are fully engaged in Centered Care, which seeks to improve care coordination and quality while reducing costs. With this program, Primary Care Providers (PCPs) coordinate services for their patients, and groups of providers are responsible for managing their health care spending efficiently. The health plans are reaching out to members to identify PCP information as part of this effort. Provider directories on the plan websites indicate physicians who are Centered Care providers; in addition, members of UniCare PLUS pay lower office visit copays for seeing Centered Care PCPs.
Check out these information sources before you make a choice.
Beginning October 1, 2014, health insurance carriers must provide health care cost information on the same day you request it, including the copay and deductible you will need to pay. Be aware that the actual cost amount can change if there are unforeseen complications. Plans have been providing this information within two days since last October. Physicians and hospitals have until January 1, 2015 to provide this same service. These requirements are part of the state’s 2012 Chapter 224 law intended to control health care costs. Most of the GIC’s health plans have a website that will help you compare costs between providers on a range of services. The GIC is also working with other state agencies on a new website that will gather health care cost and quality information in a single location.
The bottom line: Be an engaged patient! Be sure to use health care information for your own health and financial wellbeing.
This information provided by the Group Insurance Commission.