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October 8, 2018

One insurer is paying patients $550 to shop for cheaper care

Daily Briefing

    Blue Cross Blue Shield of Michigan (BCBSM) announced last month that it will gift policyholders up to $550 each year to shop for lower-cost health care services.

    Patients aren't savvy health care shoppers—but here's how providers, insurers can help

    How members can get up to $550

    With Blue Cross Rewards, BCBSM will allow 520,000 eligible preferred provider organization (PPO) group members to compare the costs of more than 140 non-emergency services. The program, which will begin Jan. 1, 2019, will reward members who use the cost compare service.

    When the member selects a reward-eligible service through their online member account, the BCBSM website or mobile app will indicate which providers offer that service and are reward-eligible. After the patient receives the service and BCBSM processes the claim, BCBSM will give the member an e-gift card worth $25 to $75.

    Eligible services include non-emergency imaging and several outpatient procedures, such as colonoscopies, mammograms, sinus surgeries, and ultrasounds.

    Lower-cost doesn't mean lower quality

    The cost of a procedure can vary by provider, but research shows that there is no correlation between service price and quality of care, Haefner writes.

    Janet Fava, VP of product development at BCBSM, said, "Often, consumers will research pricing when making significant purchases, but don't realize they can also consider value when it comes to receiving health services at a reasonable price." She added, "Many people aren't aware they have options when it comes to the provider locations they use for their different health care needs."

    According to Fava, the Blue Cross Rewards program will help members "save, earn monetary incentives, and maintain their health," by making information about service prices and provider locations more accessible.

    "We've made the functionality easy for members to navigate, so they feel comfortable exploring their options and making the best provider location choice for themselves and their families," Fava said (Haefner, Becker's Hospital Review, 9/26; MI Blue's Perspectives, 9/18).

    How to thrive in a price-sensitive market

    In this price-sensitive era, learn how to prevent volumes and collections losses by identifying the services patients are likely to shop around for and respond accordingly to maximize revenue capture.

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