Grand Rapids-based Priority Health is a nonprofit health plan that serves more than 600,000 people. Image via fb.com
Priority Health plans to become the first health care plan in Michigan to publish specific localized health care costs and quality information — by procedure, facility and physician — for its members.
The HMO has signed a contract with Healthcare Blue Book of Brentwood, Tenn., to begin publishing, this fall, costs of more than 300 specific medical services.
The constantly updated online publication for Priority Health members will also identify hospitals and doctors by name and indicate if their costs for specific procedures are high, average or low, compared to other providers in that region.
“Today, nearly half of Priority Health members have a high deductible health plan, and the number of high-deductible plans is growing dramatically statewide,” said Michael P. Freed, president and CEO of Priority Health, which is owned by Spectrum Health. “When individuals pay more out of their own pockets, they become more engaged in their health care decision making. We feel it’s our role to improve the health and lives of our members by providing the information they need to make important health care decisions.”
The escalating cost of health care has many employers urging their employees to be more involved in their own health care decision making.
Priority Health said that by making actual cost estimates available to its members, the information will allow members to spend their benefit dollars “more wisely.”
TVs v. health care
“Most consumers spend more time shopping for a new TV than for their health care,” said Jeffrey Rice, M.D., CEO of Healthcare Blue Book. “With our tool, they can understand the large differences in health care costs and compare by procedure, facility and physician to make good choices for themselves and their families, similar to the type of online support they are accustomed to when evaluating other services.”
“This tool is going to lead to a lot of educational discussions in doctors’ offices,” said John Fox, M.D., associate vice president of medical affairs at Priority Health. “Patients will be asking about their best course of treatment and how much it will cost.”
As an example, Priority Health said the cost of a knee arthroscopy may range from $1,751 to $6,087, among different facilities.
Healthcare Blue Book continuously analyzes this information to determine the current “fair price” for the procedure in each market.
In this example, the fair price would be approximately $2,110.
The guide then creates a list of facilities, indicating whether each is above, at, or below the fair price. It also will include quality information and patient reviews.