Empowering Patients can save big money for them and their health plans. When Kevin Vincent had to get two MRIs, he knew it would cost him. But he found an unexpected workaround that saved him big money – while exposing a lot of what’s wrong with American health care.
Like tens of millions of working Americans, the 51-year-old from Amarillo, Texas had a high deductible health plan. His insurance policy required him to pay the first $10,000 before the health benefits kicked in.
Vincent’s nurse practitioner referred him to a nearby hospital-affiliated imaging center for the two MRIs. How much is this going to cost? he asked when he called the imaging center.
The customer service representative told him they would charge his insurance plan $11,000 for the two tests. Vincent asked if he could get a discount by paying cash. They told him the cash price would be $9,000.
The sticker shock caused Vincent to gasp. The helpful rep told him not to worry and offered to put him on a payment plan. Thanks, but no thanks. Medical debt is not the solution for the problem of high prices! Fortunately, Vincent, who sells property and casualty insurance, had a friend who sold health benefits. He ran the prices by his buddy and learned about a better way to get the tests he needed – at a much lower price.
Vincent’s friend referred him to Green Imaging, which contracts with independent imaging centers around the country to offer cash prices for CT scans, mammograms, MRIs, X-rays and other imaging tests. The company is capitalizing on what industry insiders and researchers have known for a long time: hospital-based imaging centers have much higher prices than independent imaging centers. One study found that the price of an MRI can vary from $300 to $3,000 in the same area, with no notable difference in quality. Hospitals simply impose a markup on the same MRI or CT scans you could get elsewhere.
Vincent didn’t realize hospitals were marking up MRIs, but he gave Green Imaging a call. What he learned astonished him. The new price: $950. For both MRIs.
Vincent would not be able to apply the cash-payment to his deductible, but the process was easy. He sent his order for the MRIs to Green Imaging and got the MRIs at an imaging center about half a mile from the site that had quoted him the inflated price. Just like that he saved more than $8,000! That’s HUGE! Vincent even got the MRIs read by a radiologist and received copies of his images. He shakes his head in astonishment that he saved the equivalent of multiple mortgage payments by shopping around.
Vincent relished his own victory. But it upset him to think of people who didn’t know they could get a better deal. About 1 in 5 Americans has medical debt in collections. People like him were likely to go into debt because a hospital required them to pay more than they should. “The fact that so many people are financing this debt, and they could save so much money - I didn’t like it, frankly,” Vincent said.
Now here’s where we all need to be on guard. This unjustified price variation isn’t just related to MRIs. Health care prices vary greatly for all types of drugs and tests and treatment. This isn’t a rare thing. It’s everywhere! The business model of the American health care system is based on making working Americans pay more than they should for the care they need.
Fortunately, we have more tools than ever to see if we’re getting fair prices, including the federal government rule that now requires hospitals to post their prices – including the previously secret rates they have negotiated with each insurance plan. See if you can save yourself big money next time you undergo some type of medical treatment. Thankfully, someone helped empower Vincent.
So are you ready to take patient empowerment to the next level?
At the Mitigate Partners event in Florida, I talked about my campaign to equip and empower patients to save big money on health care. My new book, Never Pay the First Bill: And Other Ways to Fight the Health Care System and Win, is a how-to guide to help working Americans and employers save big money by hacking the health care system. The book has been a huge success. I’ve been featured on the national NPR shows 1A and Weekend Edition, Good Morning America, ABC News Live and dozens of podcasts. The book is being called a must-read for every American.
Now I’m turning it into an engaging series of health care financial literacy videos called The Never Pay Pathway (aka NPP). The short, 3-5 minute videos translate the same how-to tactics in the book into a format that’s more accessible to a larger audience. In about an hour, viewers can learn how to navigate around the pricey financial pitfalls of our health care system. The topics covered include: How to identify and contest errors and overcharges in your medical bills; how to win insurance company appeals; how to avoid care you don’t need; how to use hospital financial assistance policies; how to defend yourself in small claims court and much more. I am raising money through a crowdfunding campaign on Indiegogo to pay for the editing, graphics, animation and other production costs for the videos, as well as a smartphone app and other tools. We have great perks for people and organizations who partner with us.
My book and videos show employers and working Americans how they can work together to push back against our overpriced health care system. And it’s already showing a tremendous return on investment for the readers who are applying its principles and tactics.
Individual patients have so many ways to save money in health care. And when they save, they can actually lower the costs that they and their employers pay for their health plans. Employers also have so many ways to save money on health care. They are entering into direct primary care relationships with doctors, doing bundled payments with hospitals, reducing what they spend on pharmacy, and much more. The Mitigate Partners team has examples of employers saving massive amounts on health care benefits, while improving the benefits they provide to their employees! I show in my book how it’s already happening, and now we just need to spread the word. Let’s push back against the unjustifiably high cost of health care in the United States. When we do we can save a lot of money, while still getting the care we need.