The truth is that private health insurers have contributed nothing of value to the American healthcare system. Instead, they have raised costs and created an entitled class of administrators and executives who are fighting for their livelihoods, using customers’ premium dollars to do so. Medxoom’s member operating system makes health plans with insurance companies more efficient, but really shines with narrow networks, direct provider contracts, cash discounts, and RBP plans.
Price Calculators are one of the few tools patients have to help shed light on the murky prices across the Healthcare industry, but not always accurate. One patient, Michelle Smith, used her insurance company’s price tool to shop for the costs of her upcoming MRI. Unfortunately, the tool Smith used was incorrect, resulting in a shock when she received her bill. Smith expected to pay between $783 and $1,375 for her MRI, according to UnitedHealthcare’s price estimator, but received a bill for $3,237 because she had the MRI in a hospital, not a cheaper free standing radiology center. Had her employer used Medxoom’s proprietary pre-service price and quality comparison tool, she would have been easily notified to NOT get an MRI in a hospital for the lowest price and could have compared the same service across multiple locations outside of a hospital within her network and near her home.
Consumers know very little about the middlemen contributing to ever increasing healthcare U.S. costs. Both middlemen like Pharmacy Benefit Managers (PBMs) and secret health insurance company contract prices with hospitals recently have been discussed by lawmakers. There have been discussions in the White House and Congress to make changes to eliminate PBM rebates and to make hospital prices with health insurance companies open and public in an attempt to drive down healthcare costs. As policies continue to change, Medxoom now provides employers and employees with valuable price and quality information before service to make better informed decisions about their healthcare needs.
Health and Human Services Secretary Alex Azar called on employers to do their part in driving down healthcare costs and helping employees better navigate the health system. HHS is tasked with driving down healthcare costs and Azar is asking employers to help “do [their] part” as well. The ultimate goal is to drive down healthcare costs and help employees navigate the complicated healthcare system. Medxoom drives modern healthcare marketplaces by helping employers and employees compare provider quality and price before getting a medical procedure, resulting in lower costs and happier patients.
While the majority of doctors and hospitals are honest, a bribery and kickback trial in Texas convicting four doctors reminds us that patients need to be ever vigilant for their own health and financial interest. Patients tend to trust their doctors at their word, but need to be aware that surgery and surgical referrals are big revenue generators for hospitals and doctors and not always necessary. Powering Modern Healthcare Marketplaces, Medxoom helps provide discovery on price and quality before any medical procedure.
According to Politico, one of the biggest impacts of Obamacare is the rise in tax-exempt not-for-profit hospitals’ revenue and their concurrent reductions in charity care. High and unknown costs before service are standard procedure at most hospitals, so employers need to fend for themselves. Medxoom’s modern marketplace technologies help employers and their employees shine a light on local hospital care quality and costs so they can try to get the best outcome at the best price.
As healthcare costs continue to rise for employers, former GE CEO Jeff Immelt argues that one of the most effective ways to spark change is from CEOs themselves. If companies start to treat their own health care benefits like a business, then we should start to see some positive change in cost reductions. Medxoom helps companies lower costs, improve quality, and increase employee health benefits satisfaction with easy to use modern marketplace technologies.
The Trump Administration took a big step toward giving people more transparency for their hospital costs by signing an Executive Order on June 24, 2019. This new Executive Order should help patients and employers gain the transparency in pricing that Medxoom has been able to give through our proprietary pre-service shopping technology. While there are no immediate changes, this is the next step in the right direction. Medxoom can help now while we await the changes in the laws.
The typical self-funded employer health plan using a BUCA (Blue, United, Cigna, Aetna) PPO is paying about 275% to 350% after the highly touted BUCA “discount” of 50% off gross billed charges of 550% to 700% of Medicare for any hospital procedure. Many states are now demanding to pay less — from 150% to 180% of Medicare to save millions by not overpaying.
Medxoom can help any employer health plan member pay less by knowing what their plan’s charges are before service so employees can go to lower price higher quality providers.
As follow up to a previously posted article, U.S. Senators are proposing new laws that would require any financial incentives or other enticements paid to benefits brokers by health insurance carriers be made public. Supposedly “independent” brokers have been receiving financial incentives from various health insurance carriers, creating potential conflicts of interest that drive up costs to employers and their employees.