Staying healthy to some extent is a measure of wealth as you tend to save rather spend on your medics. This article will focus on some cost-cutters that would eventually put a big chunk of money or cash back in your wallet rather than spending all for medical bills.
- 8 Ways to Cut Your Health Care Costs
- 10 Ways to Save on Medical Bills
- 12 Low-cost Strategies For Saving on Medical Costs
- 6 Ways to Cut Down Expenses on Doctors And Healthcare
- 5 Ways Medical Practices Can Cut Costs
- How Companies Can Reduce Healthcare Costs?
- How Can Government Reduce Healthcare Costs?
- Benefits of Reducing Healthcare Costs
- How to Get Medical Bills Forgiven
- Policies to Reduce Healthcare Costs
- Solutions to Rising Healthcare Costs
- How to Reduce Healthcare Costs in Canada
- How to Reduce Healthcare Costs in America
- How to Negotiate Medical Bills
- How to Get Out of Paying Medical Bills
8 Ways to Cut Your Health Care Costs
The cost of health care continues to rise. That is why it helps to learn how to take steps to limit your out-of-pocket health care costs.
Read Also: What are Budget Busters?
Learn how to save money and still receive the care you need. Start by looking at your plan information so you know what services are available. Try the tips below to help you get the most from your benefits and save money on your care.
1. Visit Dental School
Children and some young adults love eating sugar and other confectioneries. The consumption of these food substances are in actual sense not very friendly with our body mechanism. Tooth decay and plaque are usually aggravated with the constant intake of sugar, chocolate and sweets which we cannot completely do away with in our diets.
To save some money in treating tooth decay or oral diseases, you can visit a local dental school. Most have low-cost clinics for the public, hence , giving you the opportunity to make considerable savings.
2. Register For Wellness Programme
By participating in wellness programme at your job, you would be able to cut health-care premium costs sometimes by hundreds of dollars. Most companies now plan to offer cash rewards or credits toward premiums to employees who meet certain healthy criteria for body mass index.
Endeavour to lower your blood pressure and cholesterol or you may do a work out regularly to enjoy the cash rewards or credits as the case may be
3. Dont Be Addicted To Brand Names
Getting addicted to a brand name might make you lose your sense of judgement or assessment at the expense of your hard earned money. You can choose a generic drug over a brand name to save lots of money.
Depending on what you take, you could enjoy a 52 per cent cut in the daily cost of your medications according to the FDA.
4. Take Advantage Of The Web
The web or otherwise the internet has been a tremendous place to shop for almost all you need daily. Ebay recently turned up 2,950 pairs of eyeglass frames, including Dolce and Gabbana and Gucci. You can know your size through the help of a local optician before ordering online.
You can also order contacts from an internet retailer like AC Lens (aclens.com) and save up to 30 per cent on popular brands. Other opportunities online are waiting for you to explore if you wish to save more money.
5. Get A Medical Billing Advocate
During or after a major illness, you might not be strong enough to take on the medical establishment by yourself; you need a medical billing advocate to do this for you, getting you coverage when your insurer says no or checking an expensive doctor or hospital fee.
You will surely save some money if you follow this advice when the situation arises
Even if your family income falls under certain levels, you can get health coverage and medical care for infants, children and teens through some state hospitals thereby taking away your worry of swinging insurance.
6. Participate In Group Health Plan
It is interesting to note that even if you leave your job, you still have the right, depending on your country to continue participating in your company’s group health plan for up to 18 months. With this plan, you stand a chance to save money on private policy or getting sick without insurance.
These few tips outlined are sure pointers to how you can cut down on your medical costs.
7. Plan Ahead for Urgent and Emergency Care
When an illness or injury occurs, you need to decide how serious it is and how soon to get medical care. This will help you choose whether to call your provider, go to urgent care near me, or get emergency care in a hospital.
You can decide where to get care by thinking about how quickly you need care.
- If a person or unborn baby could die or have permanent harm, it is an emergency. Examples include chest pain, trouble breathing, or severe pain or bleeding or a seizure
- If you need care that cannot wait until the next day to see your provider, you need urgent care. Examples of urgent care include strep throat, bladder infection, or a dog bite.
It’s also advisable to have a well-stocked emergency medical kit at home to handle minor injuries or provide initial care until professional help arrives. Some essential items to include are adhesive bandages, gauze pads, antiseptic wipes, scissors and. Additionally, a tongue blade for seizure can be crucial to prevent the person from biting their tongue or obstructing their airway.
You will save both time and money if you use an urgent care center or see your provider rather than going to the emergency department. Plan ahead by knowing which urgent care center is near you. Also, learn how to recognize an emergency in adults and in a child, and familiarize yourself with basic first-aid techniques.
8. Take Care of Your Health
A simple way to save money on health care is to stay healthy. Of course, that is sometimes easier said than done. But staying at a healthy weight, getting regular exercise, and not smoking lowers your risk for health problems. Staying healthy helps you avoid costly tests and treatments for ongoing conditions such as diabetes or heart disease.
10 Ways to Save on Medical Bills
For most Americans, healthcare is a top personal and financial priority. Unfortunately, provider billing mistakes combined with the skyrocketing cost of healthcare services, health insurance premiums, and prescription drugs can create real financial concerns. The good news is that there are ways to keep your medical bills in check.
1. Ask for the Cost
You might be surprised to know that you can ask your doctor to give you an estimated cost for a procedure or service before scheduling an appointment. If the cost is too high for you, an excellent time to negotiate is before your appointment or seek treatment elsewhere.
If it is a routine procedure or appointment, it may easy to “shop around” with other local doctors. In addition, you could ask for an installment plan to pay.
2. Ask About Options
Ask your physician if all the recommended tests or procedures are medically necessary, especially if you have to meet a high out-of-pocket deductible or co-pay.
3. Ask for a Discount
It is possible to negotiate a lower price for healthcare services, particularly if you are seeking a procedure or treatment offered by numerous other providers in your area.
4. Seek Out a Local Advocate
Professional healthcare advocates can provide you with information about local care options, help you obtain care, and resolve billing issues with your insurance company and/or healthcare providers.
5. Pay in Cash
While doctors might pull down some impressive yearly incomes, their offices are typically cash-poor. Doctors’ offices will frequently discount bills for patients paying cash because it eliminates their need to file insurance claims and pay credit card transaction fees.
6. Use Generic Prescriptions
Since the FDA eased restrictions on pharmaceutical companies being able to advertise directly to consumers (called DTC advertising) in 1997, Americans have been bombarded with multi-million-dollar ad campaigns promoting name-brand drugs and treatments.
According to Consumer Reports, generic drugs are as effective and safe as name-brand drugs and often cost significantly less.
7. Get Drugs by Mail or From Big-Box Retailers
You can sometimes find prescription drugs at reduced rates at warehouse club stores like Sam’s Club even if you’re not a member. Several large retail chain stores also offer significant discounts (without health insurance), such as $4 for a 30-day supply or $10 for a 90-day supply on 300-400 popular generic drugs. You can also ask your doctor to recommend a mail-order pharmacy where you can get a larger prescription package (e.g., a three-month supply instead of a typical one-month supply) for less.
8. Ask for an Over-The-Counter (OTC) Alternative
Your doctor or pharmacist can let you know if an OTC drug can treat your symptoms for less money.
9. Ask for Itemized Bills
The explanation of benefits (EOB) statement you get in the mail does not contain a detailed breakdown of all costs charged to you for services and/or inpatient stay. Specifically, ask for an itemized bill, so you know exactly what you are being charged for.
10. Review Bills for Errors
Make sure that you actually received all of the services, medications, and other items on your bill. If you notice a discrepancy or error, request copies of your medical chart and/or pharmacy ledger so that you can compare the doctor’s orders for services on your bill.
12 Low-cost Strategies For Saving on Medical Costs
Despite the complexity of the health care system, there are things consumers can do to get better health care for less. Here are 12 ways to save money on health care.
1. Pick the right insurance policy. That takes some work, Katz says. Someone in Fort Lauderdale, Florida, for example, has a choice of 94 plans through the Affordable Care Act exchange, as well as plans outside the exchange. You want a plan that includes your doctors and your medications, plus provides care for any chronic conditions. Information online can be incomplete or outdated, so call the doctors to make sure they’re still participating in plans you’re considering.
2. Shop around for medication. GoodRX.com lists cash prices for generic Lipitor in Fort Lauderdale ranging from $12.60 at Publix to $30.25 at CVS, with coupons on the site. The site doesn’t include Costco, whose pharmacy is open even to nonmembers and often has lower prices for drugs. Wal-Mart, Target and many supermarkets offer $4 generic drugs – but not the same ones – which may be less than your insurance copay.
3. Know what your health insurance policy covers. The time to dig into your policy is before you need to use it. Find out about preapprovals, emergency room visits, copays for doctor visits and coinsurance for procedures.
4. Ask whether tests, prescriptions or procedures are really necessary. The latest drugs aren’t always better than older, cheaper drugs, Reyes notes. If you tell the doctor you’re paying cash for what she orders, she may suggest you wait to see if the condition resolves before ordering an expensive test. Instead of paying for 20 sessions of physical therapy, pay for one and learn exercises to do at home.
5. Ask for prices upfront, and ask about discounts for cash payments. This may require calling your insurance company, doctor and hospital to find out what a procedure or an office visit will cost. Remember that some doctors and facilities will offer a discount if you pay cash.
6. Pick the right facility. If your condition isn’t life-threatening, don’t go to the emergency room. A persistent cough or a broken finger may be better treated in a store clinic or an urgent care center at a much lower cost. But not all clinics or urgent care centers are the same. Investigate the facilities near you before you need them so you can make the right choice when you’re ill.
7. Check bills and insurance company statements for errors. Even those with the best insurance policies often get bills for procedures that should be completely covered. A mistake in coding can mean the difference between a mammogram with no copay and one that costs $600. Be vigilant in checking both bills and explanations of benefits, a statement that summarizes which procedures and services are covered and those that remain for you to pay. Keep records of whom you talked to and when, because the calls are often recorded.
8. Get copies of all your medical test results and records. Bringing those with you to consultations can cut the number of tests and office visits you need. Often, if you’ve had a test recently, there is no need to repeat it. Plus, if you visit a doctor with test results in hand, she can advise you immediately rather than needing to set up another appointment after test results arrive.
9. Take advantage of free screenings. Every community has health fairs that offer free screenings for diabetes, HIV, high blood pressure and other maladies. By law, ACA-compliant insurance plans offer a number of screenings with no copays.
10. Negotiate big medical bills. If you go into a hospital or undergo an expensive procedure, get an itemized bill, preferably before you leave the hospital. Once you’ve made sure it’s free of errors, ask the hospital billing department for financial aid, a discount for paying in cash or a payment plan. If you have lots of big bills, consider hiring someone to negotiate for you.
11. Consider online, telephone or video consultations. Some doctors offer email consultations. American Well is among the companies that offer video consultations with doctors ($49 for 10 minutes). Some insurance companies and employer plans offer free telephone hotlines that can answer questions, sometimes 24 hours a day, to help you decide if you need an urgent care visit.
12. Practice preventive care. That means taking prescribed medications, keeping up a healthy lifestyle and visiting your primary care doctor for treatment of chronic conditions. “Chronic conditions can be better treated if they’ve not progressed to a more serious phase,” Reyes says. “To treat disease is much more expensive than to prevent disease.”
6 Ways to Cut Down Expenses on Doctors And Healthcare
Here are six ways to help you navigate the health care cost maze and potentially save:
1. Coordinate plans
Two-income couples should coordinate their insurance benefits. It might make sense to opt out of one plan and choose the family option on another. On the other hand, maintaining coverage with two providers can make sense, if one fills the gaps of the other. For example, one spouse may have better options for prescriptions, a lower deductible or a wider network of physicians.
Then, the other may be able to take the insurance benefit as a lump sum benefit. A growing number of employers are offering a “cash in lieu of” or “pay in lieu of” benefits option, under which the employer offers a taxable “opt out” amount if an employee declines coverage because they’re covered under their spouse’s health plan.
2. Check your bills
According to a Consumer Reports survey from 2014, 7% of patients found serious errors in their hospital bills. Those who paid $2,000 or more out of pocket for their care were twice as likely to find errors. These errors can range from typos and wrong codes all the way to forgetting to declare prior authorization for tests, procedures or seeing specialists.
If you spot an error, then send a certified letter requesting a corrected bill and a copy of all documentation to your insurer, and contact the billing departments of both the insurance company and the physician’s office.
3. Follow doctor’s orders
The Centers for Disease Control and Prevention (CDC) reported in September 2016 that one in four Medicare participants age 65 or older with blood pressure issues—around 5 million people—do not take their blood pressure medicine as directed. In fact, 20% to 30% of prescriptions for chronic health conditions are never filled, and about half are not taken as prescribed, according to the CDC.
Between $100 billion and $300 billion of avoidable health care costs have been attributed to non-adherence in the U.S. annually, representing 3% to 10% of total U.S. health care costs, according to a Johns Hopkins study.
4. Use medical expense deductions
If you incur extraordinary medical expenses in one year, you can deduct from your taxable income the medical costs that exceed 10% of your adjusted gross income (AGI). This can include out-of-pocket insurance premiums and a host of other expenses.
See IRS Publication 502 for the complete list, and talk to you accountant about how the deduction may apply to you. For example, if you earned $80,000 in AGI, then your threshold is $8,000. Let’s say that you incurred $10,000 of medical expenses. You could write off $2,000 on your tax return.
5. Know your plan benefits
Take advantage of the free and discounted services offered by your health plan. Many providers subsidize flu shots, gym memberships, nutrition classes, health-risk assessments and other preventive care.
6. Explore a Health Savings Account (HSA)
If you have a high-deductible health insurance plan with lower premiums, then you may wish to explore an HSA. Funds contributed are not taxed when deposited, if made through your employer. And if you’re on your own, they are 100% deductible (up to the legal limit).
Withdrawals to pay qualified medical expenses, including dental and vision, are never taxed. Interest earnings accumulate tax-deferred, and if used to pay qualified medical expenses, are tax-free. Finally, you can invest the money should you wish to take advantage of potential compound interest.
5 Ways Medical Practices Can Cut Costs
Every business, big or small, new or developed, can benefit from cutting every day costs. For medical practices, trimming some of these daily expenses means more can go into the care and support of patients. Below are 5 easy and practical ways for medical practices to save money, so you can invest more in what really matters.
1. BE MINDFUL OF SCHEDULING
To save some costs when scheduling never close over lunch, track rescheduling and adjust physician schedules and review contracts for additional compensation of E&Ms for Saturday and Sunday
2. LET IT HANDLE IT
Outsource information technology support to utilize efficient and effective use of time by staff not waiting on IT to work
3. ALTERNATIVE STAFFING
- Consider 38 hour work weeks, provide an alternative to raises and set overtime at a regular rate for two hours
- Encourage employees to go home early without pay
- Hire interns to supplement basic administrative tasks
4. LEVERAGE TECHNOLOGY
- Software vs staff
- Call in number for lab results vs nurse calling time
- Refunds to patients shown in scheduling as well as auto send refunds
5. COMPARE COSTS
Taking a look at your financial statements on a comparative basis will allow you to spot overhead items that appear to be out of line and investigate them further
How Companies Can Reduce Healthcare Costs?
Employers seeking to reduce their health care spending can consider a number of benefit design strategies other than just shifting costs to employees through high-deductible health plans. In three recent reports, researchers share their lists of the top five steps to consider beyond cost sharing.
1. Ensure quality of care through value-based designs.
Best performers tie doctor and hospital payments to evidence-based, high-quality patient outcomes. “This model aligns the patient’s and provider’s incentives toward efficient and effective care, preventing reoccurrence of illness and reducing complications, or—when treatment is needed—getting the patient the right care and the right site of service, sooner,” the report states.
In addition, 17 percent of best performers use bundled-payment approaches in their medical plans, compared with only 4 percent of high-spending companies. Bundled payments are a form of contracting that combines pre- and post-procedural care into one negotiated price that can deliver savings and simplify billing for organizations and employees.
2. Emphasize pharmacy strategies to cut overall costs.
As pharmacy benefit costs continue to climb, employers are finding ways to decrease drug expenses, such as more closely evaluating their spending on expensive specialty drugs, such as biologics that are injected or infused. Employers are encouraging the use of biosimilars as lower-cost, clinically effective options.
To curb the cost of specialty drugs, 37 percent of best performers are changing their coverage to steer care away from hospitals and toward a doctor’s office (or, if practical, self-administered at home), whereas only 19 percent of companies with above-average health care spending take this approach.
3. Offer integrated well-being programs.
As Generation Z enters the workforce and Millennials continue to advance in their careers, workers are seeking employers that encourage a healthy physical, emotional, social and financial lifestyle. For example, programs that help employees meet their short- and long-term financial goals and support a healthy, physically active lifestyle can help employees be more productive and engaged at work.
Forty-eight percent of best performers offer holistic well-being programs, compared with 34 percent of companies with higher than average health care spending.
4. Empower employees to make informed benefit decisions.
Best performers identify what the workforce needs and understand that each employee has a unique health care journey. By offering meaningful choice with a variety of benefit options, employees can personalize their benefit selection.
To meet the varied needs of employees, best performers offer tools that support personalized enrollment decisions (59 percent). Of high-cost companies, less than half (45 percent) provide these tools.
5. Mine workforce data to ensure health care strategies work.
Best performers know how to evaluate their programs to improve future benefits: 53 percent of best-performing companies—and just 34 percent of others—are using data to analyze benefit results. For instance, they may conduct multiyear evaluations of claims data and employee feedback to see if their initiatives improved employees’ health and well-being.
“As a company’s health care program becomes an increasingly integral component of its culture, the need for C-suite support is paramount,” Stone said. “Many employers have already adopted bits and pieces of these best practices, but to compete and succeed, top executives must design a vision for how their company—and its health care and benefit strategy—will evolve for the future.”
How Can Government Reduce Healthcare Costs?
1. Treat hospitals as last-resort providers.
Of every healthcare dollar spent in the United States, 33 cents go to hospitals. Another 20 cents go to physicians and clinics, while 27 cents pay for non-physician providers such as nurse practitioners, optometrists, chiropractor, and speech and occupational therapists. When hospital-owed physicians and clinics are taken into account, it’s fair to say that hospitals control more than half of all healthcare spending.
But hospitals aren’t the best place for care in many instances. Consider the lower-cost imaging centers a walk or short drive from many hospitals or day surgery centers versus expensive hospital operating theaters. Many services are inherently cheaper than identical services in a hospital setting because of lower overhead.
Of course, hospitals aren’t going anywhere, but they shouldn’t be the center of the healthcare hub. Do you go to a physical bank branch unless you have an issue that you can’t self-serve on the bank website or app? Retailers are hurting because of the prevalence of online shopping, and even grocery stores are having to rethink their business models.
Brick-and-mortar attitudes are crumbling in many industries, but hospital thinking around infrastructure is lagging behind. Price-conscious patients are seeking out lower-cost care options, which brings me to point No. 2.
2. Move care closer to patients.
Recall the last time you went to the doctor for a straightforward appointment, one where you spent 15 minutes or less in front of the physician. If you have a full-time job, how much time did you have to take off for that appointment?
If you’re lucky and got the first or second appointment of the day, you might have missed just a few minutes or an hour. More likely, though, your appointment was at 2 p.m. and you lost nearly half a day leaving work, driving to the office, waiting to be seen, seeing the doctor, checking out, perhaps picking up a prescription or making another appointment, and returning to the office.
Technology, changing consumer preferences and self-insured businesses are making more care options available. Why leave the office when you can seek medical help from a nurse line or have a virtual physician visit on your smartphone?
Nearly nine in 10 hospital executives agree that their organizations are at competitive risk from non-hospital competitors such as Optum, CVS Health, and Amazon. The number of walk-in clinics continues to grow, and more companies are setting up worksite clinics for employees.
One-third of U.S. companies with more than 5,000 employees have on-site general medical clinics, while 38% have clinics that focus on occupational health. Perhaps more telling is the 16% of companies in the 500-4,999 employee range that had general medical clinics, with another 8% saying they’d open a clinic in 2019.
There still is room for brick-and-mortar healthcare, in places where it makes the most sense.
3. Take costs out of the system.
We’ve all heard tales about the $60 ibuprofen in the hospital, when you can pick up a 200-count bottle for 4 bucks at a big box store. A woman in New Jersey was charged nearly $5,800 for an emergency room visit where she received an ice pack but no other treatment. Hospitals and other providers jack up prices on private pay patients because Medicare and Medicaid reimbursements don’t generally cover the cost of the care provided.
But there must be a happy medium where everyone pays their fair share. Consider the routine colonoscopy, a procedure that everyone 50 or over (hopefully) has undergone. Typical charges for the procedure are $2,500-$3,500, depending on the geography of the provider and the type of facility.
By my back-of-napkin calculation, the cost should be three to fives times less, or about $750. That includes well-paid medical staff using top-notch equipment in a Class A medical building who work six hours a day, seeing one patient every 30 minutes.
The move toward price transparency has the potential to create true competition among providers, with patients being able to see what is being charged for their test, scan or procedure. That surely could curtail the practice of charging exorbitantly for routine care.
4. Focus on the continuum of care.
For a patient who needs surgery, healthcare doesn’t begin on the day of the surgery, nor does it end on that day. The surgery is part of a continuum of care that starts 30 days prior and lasts a similar period of time afterward. It might start with the patient on the couch, researching conditions and providers on a smartphone.
Technology can enable greater patient choice, allowing them to choose lower acuity settings to receive care or even participate in telehealth. Smartphone healthcare apps that can access a patient’s insurance can help ensure consumers visit in-network facilities.
Hospitals and health systems can leverage technology, too, to bring efficiencies to scheduling and increase patient compliance that ultimately leads to lower costs. The 30-day, all-cause national readmission rate is 13.9%, according to 2016 data, but the rate can vary depending on payer type, geography and individual hospitals. Lowering the readmission rate by just one percentage point could save billions in healthcare costs and lost productivity.
Research from MobileSmith shows that hospitals using perioperative mobile apps can save up to $300 per procedure through a 40 percent reduction in same-day cancellations and a 7 percent reduction in 30-day readmissions.
Benefits of Reducing Healthcare Costs
1. Drop insurance completely by forcing employees to seek healthcare coverage in the exchanges. Larger employers can pay the federal penalty each year and pass the remaining health care costs directly to the employee.
This is another version of healthcare cost shifting that many companies have considered. This is exactly what Walmart did with it’s 30,000 part time employees. Others are doing the same. If dropping insurance coverage is too bold, you can do what most employers do, pass the cost increase along to your employees.
2. Change insurance carriers/ negotiate better rates in an attempt to get better pricing. Most carriers will negotiate hard to get your business. It may be possible to shave a few percentage points off the cost during year one, but soon after the honeymoon is over, cost increases continue. This strategy is usually a dead end.
3. Self insuring means employers pay for employee healthcare costs directly. With this approach the risk of high healthcare costs is born by the employer. Stop loss policies help protect against catastrophic medical costs.
Once thought to be a strategy of large corporations, there are insurance companies that will self-insure a company with as few as 50 people. This can help reduce approximately 7% of the cost that is associated with administering a fully insured insurance plan.
4. High deductible plans are more popular than ever. They are the ultimate in cost shifting. Some studies have shown that when your employees begin a high deductible healthcare plan, healthcare costs can be reduced by as much as 5-14%.
5. On-site clinics are loved by employees and they may well have a big impact on employee productivity, but it is still unclear if they can actually reduce healthcare costs.
6. Disease management includes strategies to manage the chronic conditions of high-risk, high-cost employees. The research says disease management can improve patient care and may improve health outcomes, but fails to save money.
7. Workplace health programs are one of the most effective and well accepted cost reduction strategies. The government and universities have demonstrated that effective workplace health programs don’t eliminate the drivers of healthcare costs, but they do reduce the demand for healthcare services.
How to Get Medical Bills Forgiven
Typically, medical debt is handled differently than other consumer debt by the major credit bureaus. Even if your bill goes to collections, there is a 180-day grace period before the debt appears on your credit report with Experian, TransUnion, or Equifax.
Debt forgiveness, also known as debt cancellation, happens when a creditor is no longer pursuing collection of unpaid debt. This typically doesn’t affect your credit score, but the forgiven amount could be reported to the IRS and may be taxed as income.
A debt settlement or paying less than what’s owed can impact your credit rating, and the unpaid amount may be reported as income for tax purposes.
If you owe money to a hospital or healthcare provider, you may qualify for medical bill debt forgiveness. Eligibility is typically based on income, family size, and other factors. Ask about debt forgiveness even if you think your income is too high to qualify.
Policies to Reduce Healthcare Costs
There is broad agreement on the need to address high and rising health care costs and a growing consensus on potential sources of savings. At the same time, much work is needed to develop the necessary policy interventions.
They include:
- Equalizing Medicare Payments Regardless of Site-of-Care. This brief addresses the fact that Medicare payments for similar procedures vary widely based on site-of-service, incenting provider consolidation and driving up costs for the federal government and the private sector.
- Reducing Medicare Advantage Overpayments. This brief addresses overpayments to private insurance plans in the Medicare Advantage program that reduce market incentives for innovation by allowing plans to profit from the overpayments rather than through improvements to the quality and efficiency of their product.
- Capping Hospital Prices. This brief addresses the high hospital prices paid by commercial insurance plans. On average, commercial plans pay more than twice as much as Medicare, with some hospitals charging three or four times as much. Those commercial prices are fueled by several factors, including increasing market consolidation and “must-have” hospitals using their market power to negotiate higher prices.
Solutions to Rising Healthcare Costs
The American Medical Association (AMA) has recognized four broad policies to maintain the health care expenses and get good benefits for the amount spend after health care:
Diminish the burden of avertable disease
The policy to diminish the risk factors for ailing and preventing the commencement of chronic diseases will definitely improve the patient’s fulfillment with medications and precautionary care recommendations.
This policy will also encourage enhanced nutrition and physical movement with prevention in injury due to accidents and violence. This policy will also give enhancement in carrying out more public health campaigns.
Formulate health care delivery more efficient
The policy of formulating a better health care delivery is always needed to reduce the rising expenses in health care. This will not only improve coordination of care but will also help in reducing unnecessary use of services. This particular strategy is helpful in increasing use of services with optimistic return on investment i.e. in terms of future disease and cost.
Here we can get increased accessibility of information on the usefulness of different treatments; advance management of chronic diseases. This will in turn reduce the medical errors and shift care to cost-effective sites of service.
Diminish nonclinical health scheme costs that do not add to patient concern
This particular strategy will help in eliminating unwarranted spending that does not make an addition to the value of patient concern, such as administrative expenses, profit making, etc.
Uphold value-based administration at all levels.
This successful strategy tends to improve the processes by which assessment are made so that both cost and benefit can be taken into consideration. Again particularly clinical outcomes are considered in this strategy. Both information and incentives are needed to be improved a lot for host of resolutions.
Assessment can be increasingly incorporated into such assessments as physicians and patients decide among medicinal therapies, as insurers plan health chart features, and as legislators settle on budgets or authorization coverage of meticulous benefits. (Association, 2013)
The ultimate solution to the ongoing rise in healthcare expenses cannot lie in shifting responsibilities, generating hostility among workers, and contracting the managerial screws on the system. Such solution must lie in dealing with healthcare in a truly fundamental way.
How to Reduce Healthcare Costs in Canada
Costs are controlled principally through single-payer purchasing, and increases in real spending mainly reflect government investment decisions or budgetary overruns. Cost-control measures include:
- Mandatory global budgets for hospitals and regional health authorities
- Negotiated fee schedules for providers
- Drug formularies for provincial drug plans
- Resource restrictions for physicians and nurses (such as provincial quotas for students admitted annually)
- Restrictions on new investment in capital and technology.
How to Reduce Healthcare Costs in America
Annual per capita health expenditures in the United States are the highest in the world (USD $11,172, on average, in 2018), with health care costs growing between 4.2 percent and 5.8 percent annually over the past five years.
Private insurers have introduced several demand-side levers to control costs, including tiered provider pricing and increased patient cost-sharing (for example, through the recent proliferation of high-deductible health plans). Other levers include price negotiations, selective provider contracting, risk-sharing payments, and utilization controls.
The federal government controls costs by:
- setting provider rates for Medicare and the Veterans Health Administration
- capitating payments to Medicaid and Medicare managed care organizations
- capping annual out-of-pocket fees for beneficiaries enrolled in Medicare Advantage plans and individuals enrolled in marketplace/exchange plans
- negotiating drug prices for the Veterans Health Administration.
How to Negotiate Medical Bills
1. Try negotiating before treatment
Under certain circumstances, say an emergency room visit, you’re not going to have much say in the cost of your treatment. But if you’re getting a planned surgery or procedure, then it’s possible to negotiate your medical bills before you undergo treatment.
- Get in touch with the hospital’s billing department to get an estimate of how much your procedure will cost.
- Present this information to your insurance provider to get an estimate of what your plan will cover.
- Once you know how much you’ll be responsible for, have a candid conversation with your hospital’s billing department to let them know how much you can afford.
- The billing department may recommend setting up a payment plan or applying for payment assistance programs, depending on your situation.
Don’t be afraid to ask questions like, “Is this procedure necessary?” or “How much will it cost?” After all, hospital procedures are still transactional, and you are the customer. You should know if your treatment will eventually leave you thinking about medical debt consolidation.
2. Shop around to find cheaper providers before your service
It’s common for insurance companies to offer cost estimates for services. Some companies, like UnitedHealthcare and BlueCross BlueShield, offer cost comparison tools to help you find the best price on a service you need.
If your insurance provider doesn’t offer this service, you could try a third-party website, like Healthcare Bluebook and GoodRx. These free tools allow you to compare the cost of treatment and prescription medicines.
3. Understand what your insurance covers ─ and what it doesn’t
To properly review your health care bills, you should know what is and is not covered under your insurance policy. Without this information, you won’t know how to negotiate a hospital bill.
Request a Summary of Benefits and Coverage from your health insurance company to find out where you stand when it comes to coinsurance, deductibles and more.
4. Request an itemized bill and check for errors
After your care, you’ll receive an Explanation of Benefits (EOB) from your insurance company and a statement from your health care provider. An EOB is not a bill, and it may be updated as your claim is processed. Never pay an EOB without receiving a bill from your provider and without reviewing it for errors.
5. Seek payment assistance programs
Check with your health care provider (meaning the hospital’s or lab’s billing department) to ask about any financial assistance and charity programs they offer. Hospitals have a standard procedure for helping people who can’t pay their bills. Some hospitals even have an uninsured discount for patients who don’t have adequate access to medical insurance.
If you’re uninsured and can’t imagine being able to afford your dues even with assistance, ask your provider about the possibility of medical debt forgiveness. Just be prepared to hand over proof that you really can’t afford what’s owed. Documents like tax returns and personal letters are a starting point.
How to Get Out of Paying Medical Bills
People often feel ashamed of their medical debt, seeing it as their moral obligation to pay their bills and their personal failure when they can’t afford them. What if you can’t pay your hospital bills? What if you have accumulated medical debt and have no way of paying it when it’s due? On both accounts, the consequences can be serious.
If you’re faced with medical debt you can’t pay, try these tips for reducing what you owe so you can minimize the effects of your bills on your finances, health, and future.
Check for Errors
Various sources will tell you that anywhere from 7% to 90% of medical bills contain errors.
So how do you find mistakes on your medical bills? Sean Fox, co-president of Freedom Debt Relief, a San Mateo, Calif.-based company that has helped over 450,000 million Americans get out of debt, says to start by reviewing the explanation of benefit statements from your insurer, ideally right after you receive them.
Look for duplicate items, services you didn’t receive, services you don’t recognize, and charges that your insurance should have covered. Also, review your healthcare providers’ bills to make sure your insurance has paid them accurately. Call your insurance company or your provider’s billing department to clarify anything you don’t understand or to look into any possible mistakes, he says.
A more advanced technique is to get copies of your medical records and attempt to compare them with charges for which you’ve been billed. You may need an expert’s help to secure those records and make sense of everything.
When you examine your debt, it is not about how to get out of paying medical bills, it is about making sure you have been billed correctly and for services you actually received.
Negotiate Your Bill
If you want to negotiate your bill, speak with your healthcare provider’s medical billing manager—the person who actually has the authority to lower your bill. Don’t wait until your bill is delinquent or in collections, at which point your credit score will be seriously damaged. Talk to someone as soon as you receive your bill and have verified its accuracy.
If you have a low income or are experiencing financial hardship—even if the hardship is due entirely to your medical bills—request hardship assistance. Hospital charity care may be available based on your income and savings.
In fact, according to Fox, some hospitals are required by state law to provide free or reduced services to low-income patients. As soon as your bills arrive, let your providers know if medical problems have affected your income and ability to pay.
One strategy for justifying lower charges is to compare the price you were billed to an average or fair price charged by other providers in your area. Use a website such as New Choice Health or Healthcare Bluebook to get an idea of what you should be paying. If you have health insurance, your insurer’s website might also have a tool that lets you get an estimated cost of care for various procedures.
Advocate for Yourself
On its website, Medical Billing Advocates of America recommends starting by asking for an aggressive discount for immediate payment, saying something like, “If I pay you 30% right now, will you write off the rest?” This strategy can work because your provider will save time and money if it doesn’t have to pursue payment from you for months or years.
If you can’t afford to pay even a percentage of your full bill immediately, try asking for a 25% discount if you make a large down payment now. A less aggressive strategy is to ask if the provider will charge you the discounted fee that Medicare or Medicaid pays.
If you can’t arrange a reduced payment, ask about a zero-interest payment plan. Whatever terms your provider accepts, make sure to get them in writing.
Get Outside Help
Few are experts in medical billing. A savvy choice is to enlist the help of someone who is: a medical caseworker, debt negotiator, or medical billing advocate. These professionals might be able to reduce what you owe when you can’t or are too timid to try.
Read Also: Budgeting on a Fluctuating Income
Medical billing advocates are insurance agents, nurses, lawyers, and healthcare administrators who can help decipher and lower your bills. They’ll look for errors, negotiate bills, and appeal excessive charges. Expect to pay an advocate around 30% of the amount by which your bill is reduced.
You can also ask to speak with a caseworker from your hospital or insurance company if you need help understanding your bills and resolving payment issues, says Fox. A caseworker may be able to refer you to charities, churches, community organizations, and government agencies that can offer financial assistance.
If your medical debt has caused you to incur other types of debt that you’re also struggling to pay, try using the American Fair Credit Council. This organization can help you find a reputable debt-relief company that can help reduce your principal balance and/or the interest rates on your debt to help you pay it off and restore your credit.