We believe the Affordable Care Act has a number of unintended consequences that are making life difficult for small employers in particular (have you figured out how to distribute that MLR rebate check yet?) But there is no denying that insurance carriers have a greater incentive to find ways to reduce the total cost of health care delivery. And they most certainly have leverage, and are beginning to use it.
Anthem Blue Cross has launched a pilot program in 13 California counties to help employees find lower-cost providers for imaging tests (MRI’s, CT scans, etc.): Kern, Los Angeles, Marin, Monterey, Orange, Riverside, Santa Barbara, San Bernardino, Santa Cruz, San Diego, San Luis Obispo, San Mateo, and Ventura. Sorry, Alameda, Contra Costa, San Francisco, and San Joaquin… you will have to wait a bit. But read on to find out how you and your employees can still benefit.
With typical fees ranging from $300 to $3,000 and variations of up to $1,000 for the exact same service among providers, all subscribers should be very interested. Especially with the trend towards high-deductible PPO plans, where individuals may be responsible for as much as the first $5,000 worth of services such as imaging, this can make a huge difference in out of pocket expenses.
Employers can download a quick overview of the program, and here is a one-page summary to distribute to your employees, along with a list of Frequently Asked Questions. Anthem offers direct help to employees who live in one of the 13 counties above. Other Anthem subscribers can still use Anthem’s online Cost Estimator to calculate likely costs for imaging and other services ahead of time.